Bruising easily: What are the causes?
It often comes as no surprise when you notice a major bruise the day after a painful collision with the kitchen counter. On other occasions, though, a bruise can be a bit of a mystery.
You can certainly inherit a tendency to bruise, so it is true that some people are just more likely to bruise than others.
Most bruises are not a cause for concern. General clumsiness and aging can play a role. Still, it’s a good idea to pay attention if you often get bruises for no obvious reason. “Bruising can be the body’s way of communicating a problem, especially if there are no known injuries,” says Steven Broderick, MD. He’s a family medicine doctor with Duly Health and Care in Hinsdale, Illinois.
What causes bruising?
A bruise happens when your small blood vessels become damaged, causing them to break and bleed. Most bruises come from a blow, fall, or bump and because the skin itself isn’t cut, there’s nowhere for the blood to go and it pools beneath the skin.
As the body heals and breaks down the pooled hemoglobin — a protein in your red blood cells that carries oxygen — the bruise changes color. Bruises can have different tones, depending on your skin color. At first, the skin may also appear raised. The tones of bruises often change as they begin to heal, before returning back to your regular skin tone.
Where the bruise is on the body matters, too. If it’s on the end of one of your extremities, such as your arm or leg, “that points toward bruising from minor day-to-day traumas that can go unnoticed,” says Zayd Nashaat, MD. He’s an internist with Austin Regional Clinic in Texas.
Arm and leg bruises might be from playing sports, falling, playing with an energetic dog or bumping into furniture. “But bruising in other locations, such as the face, back or chest, might indicate a more serious cause,” says Dr. Nashaat.
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8 reasons you might bruise easily
A small accident is the most common reason for a bruise. But there can be all sorts of explanations for why you might bruise easily. Many can be fixed without much difficulty. Others can be signs of bigger, and rarer, problems. Here are 8 possible reasons you bruise so easily.
As you age, your skin gets thinner and you lose some of the protective fat that cushions your blood vessels from damage. You’re also more likely to fall or bump into things due to:
- Muscle, vision, or hearing loss
- Medication side effects (these medications might increase your risk of falling)
- Certain health conditions, such as rheumatoid arthritis or diabetes
What to do: Try to lower your risk of falls by regularly getting your hearing and vision checked. And keep your body stable by staying active and doing muscle-training exercises at least twice a week.
Trip-proofing your home is important, too. According to the National Institute on Aging, 6 out of 10 falls happen at home.
So take inventory of the biggest hazards. That might mean securing rugs to the floor or clearing walking paths. Or it could involve rearranging cupboards so that your most needed items are within reach.
2. Low vitamin C
Although it’s not very common, some people may not eat enough vitamin C. According to the National Institutes of Health, vitamin C makes collagen to help wounds heal. Collagen supports solid, healthy blood vessel walls. If you’re not making enough collagen, your blood vessel walls are weaker and more likely to rupture.
What to do: If your vitamin C levels are low, your doctor might recommend that you take a supplement. Eating a well-rounded diet can also help ensure that you’re getting enough vitamins and minerals. Foods high in vitamin C include oranges, bell peppers, strawberries, tomatoes, broccoli, and white potatoes.
3. High blood sugar
When your blood sugar is high on a regular basis, it can damage your blood vessels. That can put you at risk for more bruising and also slow down how quickly your bruises heal. If fact, slow healing is a symptom of Type 2 diabetes, according to the American Diabetes Association.
What to do: If you have diabetes, it’s important to stick with your care plan and keep your blood sugar as stable as possible. That includes keeping up with doctor’s appointments, taking your medication as prescribed and getting plenty of self-care.
Recommended reading: 5 habits that can help put Type 2 diabetes into remission.
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4. Taking blood thinners
Blood thinners, such as warfarin (Coumadin®) and clopidogrel (Plavix®), are medications that can help prevent a heart attack or stroke. They work by making it harder for your blood to clot. But that also allows more blood to escape if your blood vessels get damaged. And that can cause more bruising.
What to do: If you have excessive bruising, don’t stop taking your medication. Talk to your doctor before making changes. Treat injuries or bruises immediately with ice for 10 to 20 minutes 3 or more times a day. You can also elevate bruised areas to help reduce swelling.
After 48 to 72 hours, if the swelling is gone, you can apply gentle heat to stimulate blood flow and healing.
5. Taking NSAIDs
Nonsteroidal anti-inflammatory (NSAID) medications, such as ibuprofen, are good for reducing pain and swelling. But when they’re taken for too long, they can increase your risk of bleeding.
What to do: In general, you shouldn’t take an NSAID for more than 3 days in a row for fever or more than 10 days in a row for pain, unless your doctor tells you to, according to the Cleveland Clinic.
Talk with your doctor if you’re having lasting symptoms. (In that case, a prescription pain reliever may make sense instead.)
In rare cases, bruising can be caused by certain types of cancer, such as leukemia, a cancer of the blood cells. Leukemia can lower your blood platelet count. Blood platelets help your body stop bleeding.
What to do: Don’t panic. According to the National Cancer Institute, only about 1.6% of people will be diagnosed with leukemia in their lifetime. Talk with your doctor about your symptoms. And watch for other potential signs of leukemia, such as fever, chills, unexplained weight loss, swollen lymph nodes, recurrent nosebleeds, and excessive sweating, especially at night.
7. Liver disease or damage
Blood-clotting proteins are the reason you don’t bleed out when you get a paper cut. These proteins, called coagulation factors, are largely made in the liver. If you have liver damage, your body may have trouble making enough of those coagulation factors. And that could mean bleeding and bruising more often, says Dr. Nashaat.
What to do: Be on the lookout for other signs of liver damage or disease, such as yellow skin or eyes, abdominal swelling or dark-colored urine.
There are many possible causes of liver damage. Culprits include viral infections (such as hepatitis C), alcohol misuse and nonalcoholic fatty liver disease (NAFLD). In fact, NAFLD is very common — and it often has no symptoms.
Anemia happens when you don’t have enough red blood cells to effectively shuttle the oxygen your body’s tissues need. And that can make you more likely to bruise. The most common type of anemia, called iron deficiency anemia, is due to low iron levels. (Your body uses iron to make hemoglobin.)
What to do: If you also have any of these other symptoms, you may want to talk with your doctor about testing for anemia or iron deficiency:
- pale skin
- extreme fatigue and weakness
- cold hands and feet
- dry skin and brittle nails
When to see a doctor
Bruising easily isn’t usually a sign of anything serious. But because it can sometimes indicate other health conditions, such as liver disease, it is something you should tell your doctor about. That’s especially true if your bruises don’t heal after 2 weeks, spread to other parts of the body, reoccur in the same area, or become more swollen or painful, Dr. Broderick says.
“You ultimately know your body the best, and if you sense a change, seek a medical professional’s opinion, even for basic reassurance,” he says. And if your doctor prescribes a medication as part of your treatment, we want to help you save.
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Fall-proofing your home: National Institute on Aging
Overview of vitamin C and health: National Institutes of Health
Symptoms of Type 2 diabetes: American Diabetes Association
Instructions for taking NSAIDs: Cleveland Clinic
Statistics on leukemia: National Cancer Institute