Head Bump Resolution: The Body's Reabsorption Process

A scalp hematoma ("goose egg") doesn't "go out"—it's reabsorbed by the body's natural healing mechanisms.

Physiology of Resolution

1. Clot formation: Blood extravasates into subcutaneous tissue → fibrin mesh traps RBCs.
2. Inflammation: Neutrophils, macrophages infiltrate; release proteases, cytokines.
3. Hemoglobin breakdown: Macrophages phagocytose RBCs → heme → biliverdin (green) → bilirubin (yellow) → hemosiderin (brown).
4. Color progression: Red/purple → blue/black → green → yellow → brown → gone.
5. Fibrinolysis: Plasmin degrades clot scaffold.
6. Tissue remodeling: Fibroblasts lay collagen; edema resolves.

Timeline

• Small bump: 1–2 weeks.
• Large hematoma: 3–6+ weeks.
• Calcification possible if very large (rare).

When to Worry

• Expanding mass, pulsation (pseudoaneurysm).
• Neurologic symptoms (confusion, vomiting, pupil asymmetry) — possible intracranial injury.
• Signs of infection: increasing redness, warmth, pus, fever.
• On anticoagulants/bleeding disorders.