The mysterious bruise on Donald Trump’s right hand has reappeared, once again raising questions about its cause.

The sprawling bruise was clearly visible as Trump, 78, presented the Commander-in-Chief trophy to the Navy Midshipmen football team on Tuesday.

The trophy is awarded to the winner of the American college football series among teams from the Army, Navy and Air Force academies.

Trump was seen addressing the winners while holding a football with his name inscribed on it firmly in both hands. Notably, he was wearing a championship ring on his left hand while attempting to conceal a bruise on his right hand with skin-colored makeup.

The bruise on Trump’s hand, initially noticed during a brief absence from the campaign trail in October, has reappeared in several photographs throughout the year, sparking various discussions concerning the president’s well-being.

In response to inquiries about the bruise from DailyMail.com in February, a White House official attributed the bruising to the extensive handshaking Trump engages in during his campaign interactions and current responsibilities.

The official, alleging that those repeated interactions can take a toll, said Trump greets as many people as possible. This explanation suggests why the bruise appeared in October, during the height of Trump’s presidential campaign.

But a doctor has suggested that the bruising could be from a ‘minor trauma’, such as an injury causing by bumping it or even a blood draw or IV drip.

The bruise on Trump’s right hand appears to be ‘consistent with a superficial contusion’, Dr Ola Otulana, a GP and physician at Cassiobury Court rehabilitation centre in Watford, England told MailOnline.

He said, in ‘simple terms’, the bruise is likely ‘resulting from minor trauma’.

‘This could occur from something as everyday as bumping the hand against a hard surface, repeated pressure – for example from leaning on a cane or gripping something firmly – or even medical procedures such as venepuncture, or blood draw,’ Dr Otulana explained.

The physician noted that bruising is ‘more prominent’ in older adults due to their ‘thinning skin’ and ‘more fragile blood vessels’. 

He said this can be worsened by medications such as Aspirin, blood thinners or anti-inflammatories, all of which have been known to ‘make bruises appear more easily and linger longer – which could be the case here’.

Dr Otulana said the apparent bruising on Trump’s right hand ‘doesn’t raise any immediate red flags’, but notes that if it were to persist, spread or be accompanied by other symptoms than ‘further assessment would be sensible’.

The bruise on Trump’s right hand was first spotted when he briefly left the campaign trail in October, donned a tuxedo, and spoke at the annual Al Smith Dinner in Manhattan.  

While he cracked jokes about New York’s elite, photographs of his right hand show that it appeared to be bruised, perhaps concealed by a coating of makeup.

The same bruise was captured at a different angle as he gesticulated to House Speaker Mike Johnson. Again, makeup appeared to be used to cover up the bruise. 

Later that month at a Fox News town hall, the bruise was covered again by makeup closely matched to Trump’s skin tone.

Eagle-eyed viewers first noticed his bruise during his Manhattan court battle against Stormy Daniels last spring. 

Americans got a good look at the bruise earlier this year when Trump decided to hold up one of the many executive orders he signed in his first days on the job for a photograph.

Once again, it was the same right hand Trump used to ink those executive orders, greet lawmakers, or hit a customised red button on his desk to order a Diet Coke. 

The bruise was very pronounced on February 24, when Trump would held three tense handshake engagements with French President Emmanuel Macron. 

This time, the makeup – if it was that – did not appear to closely match Trump’s pinkish, slightly tanned skin. The foundation was a darker brown than Trump’s skin.

In the absence of clear information about the bruising, speculation about it’s cause flared on social media. 

Some users alleged that it looked like a bruise left from an IV procedure. Others asked if Trump, who became the oldest president to take the oath in January might be getting ‘dehydrated and given fluids’ or even struggling from a vitamin deficiency, without providing evidence.

The White House, however, dismissed the speculation, claiming that the bruising is the result of handshaking – a key, public-facing part of the president’s job.