Dear Doctor: How long should a bruise last? I broke my fibula nearly nine months ago, but I still have a yellowish discoloration on my shin, above the fracture. What could it be? My doctor is unconcerned.

Dear Reader: When you get a bruise, or contusion, it means that the small blood vessels beneath the skin are damaged and leaking blood. This can occur as the result of a physical injury, certain nutritional deficiencies or a medical condition, such as end-stage kidney disease, leukemia, bleeding disorders and some cancers. When blood seeps into the soft tissues beneath the skin, it causes the dark coloration that we recognize as a bruise.

As a bruise heals, the body breaks down and reabsorbs the blood and lymph fluid released by the injury. During this process, the bruise goes through an array of varied and vivid colors, including bluish-purple, green, yellow and brown. How long it takes for the visible effects of the bruise to vanish depends on the location and the extent of the injury, the person’s age and their skin tone. People with pale skin tend to show bruises more readily than those with darker pigmentation, as do the elderly, whose skin becomes thinner with age. In most cases, a bruise will take from two to four weeks to heal completely.

In your case, the injury took place in the fibula, which is the smaller of the two bones of the lower leg. The fibula is long and thin and doesn’t bear much weight. Instead, its job is to help stabilize the tibia, or shinbone, as well as the ankle and the muscles of the lower leg. There are several types of fibula fractures, some of which could result in significant bruising.

The fact that visible bruising persists nine months after you broke your leg, and isn’t associated with any other symptoms, is consistent with something known as hemosiderin staining. Hemosiderin is a byproduct of the breakdown of red blood cells, which contain iron. It’s a protein compound with a brownish-yellow color and acts as a storage system for the iron left behind by the damaged red blood cells. In hemosiderin staining, the compound accumulates beneath the skin and becomes visible. Trauma, such as breaking a bone, is among the potential causes of hemosiderin staining.

You mentioned in your letter that your physician doesn’t believe the persistent color on your shin is a symptom of anything serious. We think it would be a good idea to check whether he or she agrees that hemosiderin staining may indeed be the cause. If the answer is yes, and if the condition bothers you, you have several treatment options. Topical creams can reduce the degree of pigmentation, or lighten the color. If the goal is to minimize the discoloration as much as possible, you can explore laser therapy. As with tattoo removal, it may require multiple sessions to see results.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: My sisters and I want our dad to quit smoking, but he says that he’s tried before and just can’t do it. Should he try hypnosis? Does it work?

Dear Reader: There’s no question that quitting smoking can be very difficult. Many of our patients who are trying to quit -- as well as those who have successfully stopped smoking -- tell us it’s one of the most challenging things they’ve done.

The habit hooks you on multiple levels. First, there are the physical effects of nicotine, a chemical in tobacco products whose addictive properties are considered to be on par with heroin. Nicotine acts as a stimulant in the body, and it causes the brain to release jolts of the feel-good chemical dopamine. Then there are the mental, emotional and social aspects of smoking, which quickly weave the habit into the fabric of daily life. Taken together, these make for a complex and powerful addiction that is notoriously tough to break.

Evidence suggests that hypnosis can be helpful in smoking cessation. The drawback is that techniques used by hypnotherapists are not standardized, which makes the results of this approach hard to measure.

In hypnosis, a therapist uses guided relaxation and concentration to help a person reach a mental state in which they feel simultaneously relaxed, focused and aware. Sometimes referred to as a trance, this mental state also allows the person to be more open to suggestions.

In smoking cessation therapy, a person often is asked to visualize the ways in which the habit harms the health of both themselves and loved ones. They may also be encouraged to confirm the importance of caring for their bodies. Some techniques use specific suggestions that link the scent, taste and tactile sensations of smoking to something deeply unpleasant. For example, telling the person that when they smoke in the future, they will taste scorched plastic. Hyponosis is also used to introduce positive affirmations to help bolster the smoker’s resolve to quit. For instance, “I have stopped smoking forever with ease and comfort.”

Hypnosis is often employed as a complementary smoking cessation therapy, which means it’s used together with more traditional approaches, such as nicotine patches or nicotine gum, smoking withdrawal medications, behavioral therapy and support groups.

If your father is willing to give hypnosis a chance, your family doctor can help him find a qualified professional. Studies show that people can see results after four or six sessions, particularly when hypnosis is used in conjunction with other approaches.

Your dad isn’t alone in feeling powerless in the face of smoking. In the United States, more than 34 million adults currently smoke cigarettes. This is tragic because cigarette smoking is the leading cause of preventable disease and death in the nation, and it accounts for 1 in every 5 deaths. We hope that you and your siblings will be able to persuade your dad to give quitting another try.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I heard that eating some wasabi gave a woman a heart attack. I love sushi and have it a few times a week, and I do use wasabi. Do I have to stop?

Dear Reader: Recent news reports described how a woman who ate wasabi, also known as Japanese horseradish, was hospitalized with heart problems. However, the details of the incident are important to know.

The incident you’re referring to involves a 60-year-old woman who was a guest at a wedding reception in Israel. She took a scoop of what she thought was guacamole, but instead of a smooth and creamy bite of avocado, she actually ate a large spoonful of wasabi. Moments later, her chest felt heavy, and a sensation of pressure radiated out to her arms. This lasted a few hours, then went away. The next day, feeling weak and uncomfortable, she went to the hospital. Initial tests came back with results consistent with a heart attack, but further testing failed to find any blockages or muscle damage. Instead, imaging tests showed that the woman’s heart had become misshapen, something that happens in a condition called stress-induced cardiomyopathy.

Often referred to as broken heart syndrome, the condition occurs when the left ventricle, one of the four chambers of the heart, becomes enlarged and weakened and is unable to pump blood effectively. The colorful name comes from the fact that the stressors that trigger the syndrome can be both physical and emotional, such as the loss of a loved one.

The initial confusion as to this specific woman’s condition isn’t surprising, since the symptoms of broken heart syndrome are similar to those of a heart attack. This includes the chest pain, weakness and shortness of breath that the wedding guest had experienced. Even the results of some clinical tests, including electrocardiogram abnormalities, can mirror those seen in a heart attack. Although the exact causes of broken heart syndrome aren’t known, it’s suspected that the sudden and unusual surge of stress hormones is somehow toxic to the heart muscles of some people.

Risk factors for the condition are gender and age. Up to 90% of cases are in women ages 58 to 75. People with a neurological disorder, such as epilepsy, and some psychiatric disorders may be at increased risk. Treatment is with heart medications, including ACE inhibitors to lower blood pressure; beta blockers to slow the heart rate; and anti-anxiety medicines. In most cases, the effects of broken heart syndrome are often temporary and reversible.

Wasabi is a small green plant prized for the pungent and peppery flavor of its rootstalk. It gives its name to the spicy, creamy condiment that typically accompanies sushi and other foods. It’s quite costly, though, so the bright green paste we think of as wasabi is often mostly horseradish, with a just a dash of actual wasabi mixed in. As for your concern about eating wasabi, it wasn’t the condiment itself that triggered the woman’s condition, but rather the unusual quantity that she ingested. Used in tiny amounts, as intended, wasabi shouldn’t present any danger.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)