A “goose egg” is the common term for a subgaleal hematoma, a localized collection of blood that pools beneath the scalp following blunt force trauma. This swelling occurs when small blood vessels rupture, causing blood to leak into the surrounding tissue. The forehead is especially prone to forming a prominent lump because the skin and underlying tissues are tightly stretched over the skull bone. This lack of space forces the collected blood outward, creating the characteristic, raised, egg-shaped protrusion immediately after the injury.
Immediate Steps to Reduce Swelling
The initial management of a forehead hematoma focuses on limiting internal bleeding and reducing subsequent swelling. Applying cold therapy immediately after the injury is the most effective way to constrict damaged blood vessels and slow the flow of blood into the tissue. An ice pack or cold compress, wrapped in a thin towel to protect the skin, should be applied for cycles of 15 to 20 minutes. This cold application should be repeated every one to two hours during the first 24 to 48 hours following the impact.
While direct pressure on the lump should be avoided, gentle compression applied around the area can help minimize swelling by opposing the internal pressure. Combining compression with elevation is also beneficial. For a head injury, this means resting with the head raised above the level of the heart, such as propped up with pillows. Elevating the head uses gravity to reduce fluid accumulation and pressure in the injured area.
Rest is another important component of immediate care, as physical exertion can elevate blood pressure and potentially increase bleeding at the injury site. Limiting activity allows the body to focus on stabilizing the damaged vessels. Consistent application of cold therapy and these immediate actions are crucial for mitigating the final size of the visible lump and ensuring faster resolution.
Recognizing Symptoms That Require Medical Care
While most forehead goose eggs are superficial, any head trauma requires careful monitoring for signs of a more severe underlying injury, such as a concussion or intracranial bleeding. A severe headache that progressively worsens, rather than improving, warrants immediate medical attention. Likewise, persistent nausea or repeated vomiting suggests increased pressure within the skull.
Any changes in neurological function necessitate an emergency evaluation. These symptoms include confusion, difficulty waking up, unusual drowsiness, slurred speech, or a noticeable change in behavior. Other physical signs, such as clear or bloody fluid draining from the nose or ears, or unequal pupils, indicate a potential skull fracture or brain injury. Seek professional medical care immediately if any of these warning signs appear, even if they manifest hours or days after the initial impact.
Individuals taking blood-thinning medication or those over the age of 65 should seek medical advice after any head trauma, regardless of how minor the injury seems. Consultation with a physician is also necessary if the hematoma continues to expand rapidly after cold application, or if the lump does not show signs of shrinking after a few days. These populations and circumstances carry an increased risk for complications like a delayed or significant internal bleed.
What to Expect During the Healing Process
The body naturally reabsorbs the pooled blood from the hematoma over time, a process that typically takes one to four weeks depending on the size of the lump. The appearance of the injury will change noticeably as the body breaks down the hemoglobin in the trapped blood cells. Initially, the area may be red or purple, but within a few days, it will shift to a bluish-black color as the blood deoxygenates.
As healing progresses, the bruise will metabolize and change color again, transitioning to shades of green and then yellow. This signals the final stages of the breakdown process before the skin returns to its normal tone. Due to gravity, the discoloration from the forehead may migrate downward, often appearing around the eyes, which is a normal part of the bruise resolution process.
After the initial 48-hour period of cold therapy, once swelling has stabilized, transition to a gentle warm compress to speed up blood absorption. Heat dilates blood vessels, increasing circulation and allowing the body’s cleanup cells to clear residual blood more efficiently. Warm compresses should be applied for 15 to 20 minutes several times a day to encourage reabsorption. For managing pain during the healing process, over-the-counter medications like acetaminophen are recommended.