9 Reasons You Bruise Easily

What do those bruises mean—and what can you do about them?

Bruise on woman arm. Injection bruises. Doctor and patient.
Photo: Getty Images

Scratching your head over bruises, you don't remember getting? Maybe you find yourself wondering, "Why do I bruise so easily?"

Bruising (also known as contusions) occurs when an injury crushes your blood vessels but doesn't break the skin, according to the National Library of Medicine MedlinePlus resource. The broken vessels leak under the skin. Pooled blood forms an ugly blemish that changes color and gradually fades away as the collected blood gets reabsorbed into the body.

Sometimes these black-and-blue marks pop up with little or no provocation, although clinicians say there's usually a perfectly good explanation or a treatable underlying cause.

"If it bothers you—if it recurs or it occurs and you can't explain it and you're concerned, or you have a family history of a problem—then you should see somebody," advised Margaret Ragni, MD, MPH, professor of medicine at the University of Pittsburgh and director of the Hemophilia Center of Western Pennsylvania.

Here are some common reasons that you may be bruising easily–and what you can do about it.

01 of 09

You're an Athlete or Very Active

Whether you're a competitive soccer player or a weekend warrior, you're bound to get bumps and bruises if you come into contact with other athletes or gear at the gym. It's not a big deal unless "you're worried about how your legs look while you're out on the beach," Dr. Ragni said. "But if you don't really care, I don't think it's going to hurt you to have a bruise here or there."

Minor bruises don't require treatment. But what about significant bruising due to, say, a fall, jam, or blow? To speed healing, MedlinePlus suggests to apply ice for up to 15 minutes every hour, keep the bruised area raised and rested, and take acetaminophen to reduce the pain.

02 of 09

You're Aging

Older people's bodies don't bounce back from injury like those of younger adults, so even a minor bump or grab on the arm can leave a bruise.

"As we age, our skin and blood vessels become more fragile; we lose collagen, elastin, and some of the subcutaneous fat that cushions and protects our small blood vessels," explained Suzanne Friedler, MD, a dermatologist at Advanced Dermatology PC in Manhattan.

For a fresh injury, try the RICE method: rest, ice, compression, elevation. "It may initially help a bruise from worsening, but it rarely has a benefit on a bruise after the first 24 hours," Dr. Friedler said. "After that time, heat can sometimes help the bruise clear up faster."

03 of 09

Your Skin Is Sun Damaged

Many years of sun exposure can weaken blood vessel walls, contributing to a type of bruising in older adults known as "actinic purpura"—purple patches that occur on the backs of the hands and forearms without much of a bump or injury. (Aging and use of certain medications can also cause these bruises.)

The American Osteopathic College of Dermatology said daily application of alpha-hydroxy acid (AHA) cream, or tretinoin cream may thicken the skin and help a bit. But wearing long sleeves and avoiding trauma to the hands and arms may help prevent bruising in the first place. And it's another reason to become a lifelong user of sun protection!

04 of 09

You're Taking Blood Thinners or Painkillers

Taking the blood thinner warfarin or using nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen can lead to easy bruising, especially in older people who are frequent users of these medicines.

NSAIDs and blood thinners block the normal function of platelets, a component of blood that binds to other clotting factors to stop bleeding, Dr. Ragni, who is also a spokesperson for the American Society of Hematology, explained. While popping a pill now and then probably won't cause a bruising problem, long-term use could be the reason you're bruising easily.

Consult your healthcare provider before stopping any medication.

05 of 09

You're on Steroids

Do you have asthma, COPD (chronic obstructive pulmonary disease), eczema, or rheumatoid arthritis? Easy bruising may be a sign that you're taking corticosteroids, a common treatment for these and other diseases.

Whether you're using an inhaler, taking pills, or applying a topical version of these powerful anti-inflammatory drugs, bruising is a common side effect. Long-term use may cause skin thinning, according to a 2021 review published in BMJ Open.

If bruising is an issue, talk to your healthcare provider about whether to stick with your medication regimen or switch to another drug.

06 of 09

Your Blood Platelet Count Is Low

If bruises seem to appear for no reason, it could signal you have a rare platelet disorder. Blood platelets are crucial because they help form clots to slow or halt bleeding.

"You can either have an insufficient number of platelets, or your platelets don't work normally," Dr. Ragni said.

It's uncommon, but thrombocytopenia, a low platelet condition, can develop during pregnancy—and one of the first signs can be a bruise. "That's the sort of thing a hematologist could help you sort out," Dr. Ragni said.

07 of 09

You Have a Bleeding Disorder

Bruising in and of itself may not be a big deal. But when it's accompanied by other symptoms, like nosebleeds, heavy periods, or excessive bleeding after surgery, then you might suspect something more than just accidental bruising. "It's the company it keeps, the frequency that it occurs, even the severity by which it occurs," Dr. Ragni explained.

The most common bleeding disorder, called von Willebrand disease, is a genetic condition caused by a missing or defective clotting protein, according to the National Hemophilia Foundation. It affects up to 1% of the population.

People with bleeding disorders require specialized treatment, beginning with a thorough evaluation by a hematologist.

08 of 09

Your Liver Is Hurting

If your liver is diseased or damaged, there may be fewer platelets circulating in your blood than you need for normal blood clotting, and that can cause you to bruise easily, Dr. Ragni said.

Many things can cause liver damage, from hepatitis C infection to alcohol-related liver disease.

You could even have a liver disease and a bleeding disorder. "You want to have a very thorough evaluation to make sure you're not just attributing [bruising] to drinking and liver disease when it may be something else entirely," Dr. Ragni said.

09 of 09

You Could Have Blood Cancer

Although exceedingly rare, easy bruising is a common symptom among people with blood cancer. People develop these bruises due to a dearth of healthy blood cells in the bone marrow. They aren't producing enough platelets needed for clotting.

One telltale sign of cancer-related bruises: They tend to occur in unexpected places, like the back or hands. People often develop multiple, unexplained bruises at a time. The bruises tend to take longer than a week to go away, with new bruises showing up for three days, according to the American Cancer Society.

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