A scalp bruise (also called a head contusion) happens when small blood vessels under the scalp leak blood after an injury. The trapped blood might show as red or purple marks on the scalp, or it may be hidden by the hair. A bruise usually hurts when touched, especially for the first few days after the injury. Most bruises heal within about 2 weeks.

The health care provider did not see any signs of a brain injury (concussion) at this time. You or another responsible adult must watch your child for concussion signs for a few days. Here's what to watch for and how to care for your child.

Concussion signs to watch for include a headache, nausea (feeling sick to the stomach), dizziness, vomiting, changes in behavior (such as agitation or confusion), being very sleepy, confusion, and seizures.

• Call your health care provider if your child has a mild headache or feels sick to their stomach.
• Call 911 or go to the ER right away if your child is sleepier than usual or has a severe headache, is dizzy, is vomiting, has changes in behavior, seems confused, or has a seizure.

Daily activities:

• Your child can keep their usual sleep schedule. 
• Your child can go to school and do most usual activities. But for a few days, they should avoid rough play and sports (like football, skateboarding, and soccer) that could lead to another head injury.

For 2–3 days, to help with pain and swelling:

• If your health care provider says it's OK, give your child medicines like acetaminophen (Tylenol^® or a store brand) or ibuprofen (Advil^®, Motrin^®, or a store brand) as needed for pain. Follow the directions on the label for how much to give and how often. Your health care provider may not want you to give pain medicines because they may cover up a headache, which can be a sign of a brain injury.
• Place ice wrapped in a towel on the bruise for about 20 minutes several times a day. Do not put ice directly on the skin.

Follow your health care provider's advice for:

• If you should try a heating pad or massage (usually about 2 days after the injury).
• When to follow up.

• The pain or swelling gets worse.
• Your child has a headache or feels sick to their stomach. 
• Within 2 weeks:
  • The bruise and pain haven't gone away.
  • Your child seems to have a lot of bruises or gets bruises for no clear reason.

Call 911 or go to the ER if your child:

• is very sleepy or has a severe headache, dizziness, vomiting, changes in behavior, or confusion
• has a seizure

How do health care providers diagnose a bruise? Health care providers carefully examine the injured area and ask about what happened. For a bruise on the scalp, they take special care to make sure there are no signs of a concussion. 

How do bruises heal? Bruises usually go away in 2 weeks. While it heals, the bruise changes color as the body breaks down the blood. If the bruise is under the hair, you may not see these changes:

• At first, a bruise looks red or pink because of the trapped blood under the skin.
• Within 1–2 days, the bruise will look bluish-purple or sometimes black.
• After 5–10 days, the bruise looks green or yellow.
• After 10–14 days, the bruise may turn yellow-brown or light brown.

Can bruises be prevented? Most kids will get bruises from time to time. But it can help to:

• Wear protective gear and helmets for sports.
• Use proper technique during sports and practices.
• Keep floors clear of clutter or things your child can trip on.