Do You Bruise Easily? When to Get It Checked Out

Some over-the-counter medicines such as aspirin, non-steroidal anti-inflammatory drugs (like ibuprofen), Plavix® (clopidogrel) and blood thinners (like Coumadin®) can increase your tendency to bruise. So can prescription medicines, such as certain antidepressants.

What to know about bruising easily

Minor bruises often heal in a few days. Some people bruise more easily than others, and the bruising can take longer to heal. Causes include age, medications, and vasculitis.

A fall, blow, or anything else that exerts sudden high pressure on the skin can cause a bruise. Very forceful blows can damage bones, causing deep bleeding and bruises that take several weeks to heal.

Some people bruise more easily than others. They may notice bruises but not know why they happened. They may also develop large bruises after minor injuries or have bruises that take many weeks to heal.

Factors that increase the risk include older age, having a condition that affects blood clotting, and using medications such as blood thinners.

Here, find out some reasons one person may bruise more easily than another.

Patients, too, are unhappy with the care they receive during those brief interactions with their doctors. Healthcare communications company West Corporation reported that 25% of patients don’t feel that their provider cares about them as an individual and nearly 20% aren’t convinced their doctor is focused on improving their health – even though 93% of doctors strongly agree that patient satisfaction is important.

A bruise develops when blood vessels become damaged, and blood leaks into tissues under the skin. This causes the characteristic black or purple color of a bruise.

On dark skin, bruising may also appear red or purple, or it may show as a darker area than the surrounding skin, depending on the person’s skin tone.

In time, body tissues absorb the blood, and the color fades.

Some signs that an individual bruises more easily than an average person include:

developing very large, painful bruises after minor injuries
having many bruises without remembering their cause
frequently developing bruises that take many weeks to heal

Numerous factors can cause a person to bruise more easily. The most common include the following:

People tend to bruise more easily with age, because blood vessels weaken, and the skin thins.

Easy bruising may also run in families, so individuals whose relatives bruise easily may notice that they do too.

Medications

Blood-thinning medications may cause a person to bleed and bruise more.

Some popular blood thinners include:

warfarin (Coumadin)
heparin
rivaroxaban (Xarelto)
dabigatran (Pradaxa)
apixaban (Eliquis)
aspirin (Bayer)
ibuprofen (Advil)
naproxen (Aleve)

Some other medications may weaken or change the behavior of blood vessels, worsen inflammation, or otherwise increase the risk of bleeding. They can include the following:

some herbal remedies, such asginseng, flaxseed, and saw palmetto
corticosteroids
some chemotherapy drugs and targeted therapy, which can lower platelet levels in the blood

People taking medication who notice an increase in bleeding or bruising should ask a doctor whether their medication can cause bleeding. They may wish to discuss the risks and benefits of continuing treatment.

Liver disease

Cirrhosis and other conditions can have an impact on liver function. Liver disease can affect blood clotting, which can increase the risk of bleeding and easy bruising.

Other symptoms of liver disease include:

itching
fatigue
a general feeling of being unwell
swelling in the legs
dark urine
yellowing in the whites of the eyes, a sign of jaundice

Alcohol is a major contributing factor to liver disease, but the condition can also result from cancer and other health issues.

Bleeding disorders

Many genetic conditions can affect blood clotting.

Von Willebrand’s disease, the most prevalent bleeding disorder, affects about 1% of the population. A person with this condition has little or no von Willebrand protein, which is important for blood clotting. Synthetic hormone treatment can improve blood clotting in people with the condition.

Hemophilia involves low levels of blood clotting factor VIII (hemophilia A) or factor IX (hemophilia B). Both proteins are important for blood clotting. Synthetic versions of these clotting factors can help treat hemophilia and reduce the risk of serious bleeding and bruising.

A person with a genetic bleeding disorder has a higher risk of bruising and excessive, possibly life threatening bleeding. The bruises will look like regular bruises, but they can be larger.

The symptoms will be present from birth and can affect babies and young children.

Vitamin deficiencies

Certain vitamins enable the body to heal and the blood to clot.

Low vitamin C levels can cause a condition called scurvy. The body uses vitamin C in creating collagen, an essential part of the structure of blood vessels. In scurvy, the blood vessels weaken, resulting in:

bleeding gums
wounds that do not heal
easy bruising

Vitamin K helps the body form clots to stop bleeding. Newborns often have very low levels of vitamin K, which are insufficient to stop bleeding. Without a vitamin K injection at birth, babies may bruise easily or bleed excessively. Adults with low vitamin K levels may also notice a sudden increase in bruising.

A doctor can carry out tests to see whether a person has a vitamin deficiency. In some cases, supplements or a change in diet can help. In other cases, an underlying health condition, such as inflammatory bowel disease, may need addressing.

Vasculitis

Vasculitis refers to a group of conditions that cause inflamed blood vessels.

increased bleeding and bruising
shortness of breath
numbness in the limbs
ulcers
skin lumps
purple spots on the skin, known as petechiae

On dark skin, petechiae may not always show up, which means a doctor could miss them. They may be visible in areas with less melanin, such as the forearms.

The type of treatment depends on the severity of the vasculitis and which area of the body it affects. Several medications, including steroids, may help.

Senile purpura

Senile purpura is common among older adults, affecting around 10% of those aged over 50 years. It causes dark purple bruise-like lesions on the skin and is most likely to develop on the arms and hands.

They are more common in people with light skin, but anyone can develop them. On Brown and Black skin, they may appear purple or as darker skin. The skin around may be thinner and less elastic.

The lesions often appear after an injury to the skin but last longer than bruises and can be much larger. Sometimes, the skin remains brown after the lesion heals.

Ways of reducing the risk of bruising include:

protecting the skin from sunlight
taking care to avoid injuries
being aware that corticosteroids and blood-thinning drugs can worsen symptoms

Senile purpura does not have links with any serious health condition, but it may increase the risk of skin tears.

Cancer

Rarely , an increase in bleeding and bruising may be a sign of leukemia. This is a type of cancer that affects white blood cells.

There are different types of leukemia, and symptoms vary.

Often, there are no symptoms in the early stages, but a person may notice:

bleeding
bruising
petechiae, small spots under the skin, like a rash, where blood vessels have broken
fever
fatigue
bone pain
heavy menstruation
abdominal swelling

Petechiae may not be visible on dark skin, but a person may see them on areas with lower levels of melanin, such as the forearms.

Anyone who experiences these symptoms should seek prompt medical advice, as early treatment is often effective.

Bruises usually fade in time and do not need treatment. However, first aid after an injury may help reduce swelling and discomfort.

Do older adults bruise more easily?

Older adults often bruise more easily, because the skin becomes less flexible with age, and there is less fat to protect the blood vessels. Sun exposure can also increase the risk.

Does diabetes affect bruising?

In people with diabetes, wounds, including bruises, can take longer to heal.

What is the treatment for a bruise?

Bruises usually heal without treatment, but raising the bruised part and applying ice covered in a cloth may help reduce swelling.

In most cases, a person who bruises easily is unlikely to develop complications after a bruise.

However, easy bruising can be a sign of an underlying condition and a higher risk of bleeding overall.

Anyone who notices they are bruising more often or more easily than usual should seek medical advice to rule out other health issues or seek treatment as appropriate.

Last medically reviewed on April 25, 2022

Dermatology
Alcohol / Addiction / Illegal Drugs
Blood / Hematology
Liver Disease / Hepatitis

How we reviewed this article:

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Do You Bruise Easily? When to Get It Checked Out

You may never pinpoint the source. The bruise eventually disappears, along with your concern. But bruising shouldn’t always be dismissed so easily, says hematologist Dana Angelini, MD.

“It’s common to bump into things, not remember, and see small bruises on your legs or arms,” she says. “However, unprovoked bruises on your torso, back or face are unusual. And that’s a reason to get them checked out.”

Here’s what you should know about bruising.

How bruises develop

You may get a bruise from a bump or injury to the skin or the tissues beneath the skin. Since the skin isn’t cut or broken, you won’t see external bleeding. But damage to blood vessels below the skin causes them to rupture and leak blood.

Blood pooling and clotting beneath the surface causes skin discoloration. At first, the skin is often red or purplish. As the bruise heals, it may turn brown, green or yellow. The area often is swollen, tender or painful.

Why do I bruise so easily?

Minor accidents — running into furniture, falling, dropping something on your leg, hand or foot — are the most common cause of bruising.

Some over-the-counter medicines such as aspirin, non-steroidal anti-inflammatory drugs (like ibuprofen), Plavix® (clopidogrel) and blood thinners (like Coumadin®) can increase your tendency to bruise. So can prescription medicines, such as certain antidepressants.

“Even over-the-counter supplements such as garlic, ginkgo, ginseng and fish oil can inhibit normal platelet function and cause bruising,” Dr. Angelini says.

Age is another factor. Older adults may bruise more easily than younger people. Their thinning skin often has less fat underneath to cushion the blood vessels.

Other possible causes of bruising include:

Deficiencies in vitamin B12, vitamin C or vitamin K.
Blood disorders such as Von Willebrand disease, hemophilia, platelet function defects or other blood clotting disorders.
Domestic, child or elder abuse.
Severe alcohol abuse.
Malnutrition.

When bruising is cause for concern

Bruises due to minor injuries or accidents usually disappear on their own after a week or two. During the healing process, the bruise will change color before fading away. But it’s a good idea to get a bruise checked out by your doctor if it:

Shows no signs of improvement after a week.
Is located on a part of your body where injury or accident is unlikely.
Keeps occurring or comes back.
Is unusually large and unprovoked.

During an office visit, your doctor will review your family and personal medical history. You’ll answer questions like:

Do any family members have an inherited blood disorder?
Have you been bleeding from your nose or oral cavity?
Have any surgeries resulted in above-average bleeding?
Which medications and supplements do you take; have you recently started new ones?
If you’re a woman, has your menstrual flow been heavier?
Have you had other blood loss, such as in the urine or stool?
Have you ever had bleeding in unusual locations, like the joints, muscles or brain?

If your doctor decides medication is probably causing your bruising, they will discuss other options. “We’ll do a risk-benefit analysis,” Dr. Angelini says. “If life is going well, we might opt to keep you on the drug if it’s helping you control another disease. If the bruising is severe or interfering with your daily life, we’ll talk to the prescriber about replacing it with another medication.”

When the cause of bruising is unclear, your doctor will likely order blood work to check for platelet problems or other blood clotting abnormalities.

But don’t hesitate to ask your doctor for help. “We do a lot of consultations for bruising. When a serious bleeding disorder is ruled out, we’re happy to provide reassurance,” she says.

Do You Bruise Easily? When to Get It Checked Out