I bruise easy

Why Do I Bruise Easily? Reasons It May Happen

Medically Reviewed by Nayana Ambardekar, MD on April 23, 2022

It happens every so often. You notice a purplish mark and think to yourself, “Where did that come from?” Bruises are common. When you bump into something, like your bed or couch, you may injure tiny blood vessels. Blood may pool under your skin and leave the telltale mark. And if you bruise easily, there are many reasons that could explain it.

You may notice more bruises as you age. You slowly lose the fatty layer underneath your skin. Your blood vessels weaken and can be injured easily. That means you have less protection to soften a bump against a table or chair.

Certain medications -- like aspirin, ibuprofen, and blood thinners -- may get in the way of your body’s ability to form a clot. Some antibiotics may also leave you prone to bruising. Other medications like steroids can make your skin thinner and more fragile. This can also lead to more bruises. Talk to your doctor if you notice more black-and-blue marks.

Just like dimples, freckles, and curly hair that run in the family, whether or not you bruise easily can, too. Women also tend to have more delicate blood vessels, especially on the upper arms and thigh. Thin or weak blood vessels can be easily injured and leave a purple mark.

Sunburn, peeling skin, and skin cancer risk aren’t the only hazards of too much sun. You may also find purple blotches on the back of your hands or arms. Years and years of sunning yourself can weaken the walls of your blood vessels. This can make them vulnerable to damage that leads to bruises.

Easy bruising can be a side effect of some over-the-counter dietary supplements such as ginkgo, ginseng, and garlic. They can thin your blood and make it harder for blood to clot after you knock into something.

This essential vitamin helps make collagen, an important protein that keeps your blood vessels healthy. If you don’t get enough vitamin C in your diet, you may notice that you bruise easily. While it’s uncommon to have low levels of vitamin C, it’s more likely if you smoke.

You know that physical activity is important for your health. But an intense session may leave you with more than just sore muscles. You may get tiny tears in your blood vessels when you push yourself physically or play contact sports. That can lead to bleeding underneath the skin. You should still be active, but don’t overdo it.

You probably know that diabetes is a condition where your blood glucose levels are too high. Over time, uncontrolled high blood sugar can also damage your blood vessels. This can make you more prone to bruises. And they may linger longer, too.

Vitamin K may not get as much attention as some other vitamins. But it plays an important role in blood clotting. If you don’t get enough vitamin K, you could get more bruises. Still, most healthy adults get enough of this vitamin from foods like leafy green vegetables.

In some cases, unexplained bruises may be a sign that your blood cannot do its job well. For example, if you have a condition like hemophilia, you don’t make enough proteins that help your blood clot. Without these proteins, you may bruise easily. But these conditions aren’t common and often come with other symptoms like fever, chills, and weakness.

A drink or two won’t necessarily lead to unexplained black-and-blue marks. But if you drink often and notice frequent bruises, it may be a sign of that your liver isn’t doing its job as well as normal. If your liver is damaged, it doesn’t make enough proteins to help your blood clot. That can account for the bruises.

This isn’t a likely reason for bruising. But in rare cases, red or purple bruises could be sign of cancer like leukemia. With leukemia, your body makes a lot of white blood cells. These cells start to crowd out other blood cells. That can make it hard for your blood to do its job and may lead to bruises.

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SOURCES:

Harvard Health Publishing, Harvard Medical School: “Is my bruising normal?”

American Family Physician: “Easy Bruising and Bleeding. ”

Genetic Science Learning Center: “Observable Human Characteristics.”

Cleveland Clinic: “Do you bruise easily? When to get it checked out.”

NorthShore University Health System: “Why do I bruise so easily? Common causes, facts and treatment.”

American Osteopathic College of Dermatology: “Bruising Hands and Arms.”

University of Maryland Medical System: “Vitamin C (Ascorbic Acid).”

U.S. Department of Health and Human Services: “Importance of Physical Activity.”

American Academy of Orthopaedic Surgeons: “Muscle Contusion (Bruise).”

Go Ask Alice: “Unexplained bruises.”

National Institute of Diabetes and Digestive and Kidney Diseases: “What is Diabetes?”

American Diabetes Association: “Diabetes Symptoms.”

Merck Manual: “Vitamin K Deficiency.”

Merck Manual: “Bruising and Bleeding.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Symptoms & Causes of Cirrhosis.”

Johns Hopkins Medicine: “Liver: Anatomy and Functions. ”

Healthier Hawai’i: “Love Your Liver: Look for These 8 Signs of Organ Damage.”

Familydoctor.org: “Leukemia.”

Why do I bruise easily? 8 possible causes

Bruising happens when blood becomes trapped under the skin, usually due to an impact that damages a small blood vessel. Minor bruises often heal in a few days. Some people bruise more easily than others, and the bruising can take longer to heal.

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.

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.

Here, learn more about how bruising appears on dark skin.

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.

Learn more about the symptoms of liver disease here.

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.

Symptoms include:

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.

What is a leukemia rash?

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

First aid for a bruise after an injury involves:

ensuring the person is comfortable
raising and supporting the injured part
applying a cold pack or ice wrapped in a cloth for 20 minutes, as this can reduce swelling

Never apply ice directly to the skin.

Other treatment options include using pain relief medication, such as ibuprofen. Some people apply arnica to the skin, but there is not enough evidence to show it speeds up healing.

People who bruise easily may need medical help for an underlying condition.

How can I get rid of a black eye?

People should consult a doctor about easy bruising if:

bruising occurs more often or more severely than before
they have other symptoms, such as fever, low energy, or skin changes
they are taking medication and begin bruising more easily
bruises are slow to heal
they notice petechiae, small red spots resembling a rash under the skin
they develop purpura, purple patches under the skin

A person should seek emergency help if a large bruise develops after a trauma, especially if they also have lightheadedness or dizziness. These could be signs of internal bleeding.

What do the colors of a bruise mean?

Here are some questions people often ask about easy bruising.

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.

Important! Why Bruises Easily: 9 Worrisome Reasons

Bruising from time to time is almost inevitable, but if you get bruises often enough that you can't figure out why, then there must be a reason. Maybe you just hit your hand or foot and forgot about it, but it could just as well be something completely different.

Age . With age, the skin loses some of its protective fatty layer, which, like a pillow, protects against bumps and falls. In addition, the skin becomes thinner as collagen production slows down. This means that it usually takes much less force to form a bruise than when you were younger.
Hemorrhagic vasculitis . This vascular disease results in thousands of tiny bruises, most commonly on the shins that look like they've been sprinkled with red pepper. Bruises are the result of blood leaking from small capillaries.
Blood disorders . Blood disorders such as hemophilia and leukemia can cause unexplained bruising, usually because the blood doesn't clot properly. If you frequently develop severe and unexplained bruising, you may want to see a doctor to rule out such disorders, especially if they appear suddenly.
Diabetes . People with diabetes may develop dark pigment spots, often where the skin comes into contact with other parts of the body. These spots may be mistaken for bruises, but they are actually due to insulin resistance.
Excessive training stress . Excessive muscle tension, such as when lifting heavy weights, can lead to rupture of blood vessels and bruising. Bruising can also cause microscopic tears in muscle tissue. In addition, if you play sports or vigorous exercise, you may have bumps and minor injuries that cause bruising, but you do not remember about them.
Certain drugs . Medicines such as aspirin, anticoagulants, and antiplatelet drugs reduce blood clotting and increase the chance of bruising. And drugs like aspirin, prednisone, prednisolone, oral contraceptives, and others can also weaken blood vessels, increasing the chance of bruising.
Heredity . If you have close relatives who bruise easily, then it's entirely possible that you'll be prone to it too (although there are usually steps you can take to avoid succumbing to this potential genetic tendency).
Pale skin . Pale skin doesn't mean you're prone to bruising—it's just that any bruising is more visible than in people with darker skin.
Sun damage . While the body needs sun exposure to produce vitamin D (and get additional benefits), overexposure to the sun, especially when it results in burns, can cause the skin to lose its suppleness and resilience. This, in turn, makes bruising easier and more visible.

What to do if bruises appear for no reason And some of them are very dangerous.

Why do bruises appear? Just hidden.

Bruising is the result of damage to the capillaries located under the skin. The mechanism of their formation is simple: hit - the capillaries suffered - the blood that spilled out of them formed a subcutaneous hematoma, the same bruise. If you didn’t hit, but there is a hematoma, then the capillaries were damaged for a different reason.

If bruises appear regularly for no reason, it means that the capillaries are suffering due to some systemic internal malfunction of the body.

Lifehacker collected the 7 most common cases.

1. Deficiency of vitamins and microelements

Some vitamins (for example, K and B12) are largely responsible for the composition of the blood and its ability to clot. Others - the same vitamin C - for the strength of the walls of blood vessels, including the smallest capillaries. Zinc and iron are necessary elements for the rapid healing of various injuries, including capillary ones. Bioflavonoids (citrine, rutin, catechin and quercetin) also affect the condition of the capillary walls.

With a deficiency of these substances, bruises appear much more easily and more often than usual: the vessels become brittle and fragile, and the body does not have enough strength to quickly block the bleeding.

2. Strength training

Stress associated with exercise can cause blood vessels to burst. Look into the eyes of athletes lifting record weights - notice bursting blood vessels around the pupils. And for some "lucky ones" even the nose bleeds with a particularly intensive approach.

This also applies to capillaries under the skin of the limbs and torso, so bruising on the body is a completely predictable turn with excessive enthusiasm for the barbell and other elements of strength fitness.

3. Taking Certain Medications and Supplements

Popular painkillers such as ibuprofen and aspirin thin the blood and impair its ability to clot. The same goes for corticosteroids, as well as many of the favorite dietary supplements - fish oil and ginkgo biloba.

What is there! Even garlic, if used in moderation, can cause poor blood clotting. And this is a direct path to the formation of fairly extensive hematomas, even with the most minor blows.

4. Aging

With age, the skin becomes thinner, becomes more pale and transparent. Because of this, even small hematomas, which you would not have noticed in your youth, begin to clearly shine through the skin. The changes also affect the vessels: they become more fragile and easily break from minor injuries.

An obvious example of such changes is a disease called senile purpura, accompanied by the appearance of bruises. This disease affects 10% of people over 50 years of age.

5. Existing or developing diabetes

Diabetes is not just about blood sugar. This metabolic disorder affects the entire body, including the circulatory system. The symptoms are the same as above: the vessels become more brittle, the blood coagulates worse, and bruises appear, it seems, even from a breath of wind.

6. Diseases associated with blood clotting disorders

Willebrand's disease, thrombophilia, thrombocytopenia... Some of these diseases are hereditary, some are acquired, but they all have a common symptom: bruises and bruises form almost without reason.

7. Oncology

Leukemia in particular. One of the first symptoms of this disease is the appearance of bruises of unknown origin all over the body. This is again due to a sharp deterioration in blood clotting.

What to do if bruises appear for no reason

If you carefully read the text above, you already understand: such bruises can be completely innocent, or they can indicate serious problems.

In order not to miss the moment of occurrence of a really terrible disease, it is important to pay attention to hematomas, the origin of which you are not sure.

Keep track of how the bruises behave in the following days. If they stubbornly do not heal, increase in size, or new unexplained bruising appears, it is necessary to consult a therapist as soon as possible.

If everything goes well and the tests show no trouble, the doctor will recommend:

Correct your diet to get the required amount of vitamins and microelements.
Be less zealous in training.
Refuse blood-thinning drugs and dietary supplements, replacing them with analogues.
Use creams and ointments that strengthen the walls of blood vessels.

Normally, this is enough to rid the skin of unaesthetic bruises and prevent their occurrence in the future.

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