Bruising Easily: 9 Reasons This May Be Happening

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

Bruise on woman arm. Injection bruises. Doctor and patient.
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If you find that you tend to bruise easily, you're not alone. It's a common complaint that healthcare providers see, and research has noted that easy bruising occurs in 12% to 55% of healthy individuals.

What Is a Bruise?

A bruise (also known as a contusion) occurs when an injury crushes blood vessels but doesn't break the skin. The broken vessels leak under the skin. Pooled blood forms a 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 reason, but there's usually an explanation or a treatable underlying cause.

Here are some common reasons a person may bruise easily–and what to do about it.

Reasons for Bruising Easily

An Active Lifestyle

Whether you're a competitive soccer player or a weekend warrior, bumps and bruises can happen after contact with other athletes or gear at the gym.

Bruises may result from minor injuries (e.g., sports injuries), falls, or collisions. Additionally, a person might be more likely to sustain injuries during sports or exercise for a number of reasons, such as if they:

  • Don't use exercise techniques correctly
  • Run or jump on hard surfaces
  • Change exercise intensity too fast

Of note, though bruising may occur with sports injuries, those injuries can happen to anyone active in some way (e.g., painters, gardeners).

Age

For older individuals, a minor bump or touch on the arm may leave a bruise. That's partly because as the skin ages, it starts to lose its strength and takes longer to heal after injuries or if the skin breaks.

"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.

Sun-damaged Skin

Years of sun exposure can weaken blood vessel walls, contributing to a type of bruising in older adults known as "actinic purpura." Actinic purpura is a condition where purple patches occur on the backs of the hands and forearms without much of a bump or injury.

Daily application of alpha-hydroxy acid (AHA) cream, or tretinoin cream, may thicken the skin and help a bit. Wear long sleeves and avoid trauma to the hands and arms to help prevent this type of bruising.

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.

NSAIDs and blood thinners block the normal function of platelets, a component of blood that binds to other clotting factors to stop bleeding, explained Margaret Ragni, MD, professor of medicine at the University of Pittsburgh and director of the Hemophilia Center of Western Pennsylvania.

More About Blood Thinning Medicines

These types of medications may be considered anticoagulants or antiplatelets. Anticoagulants are medicines that slow the body's ability to make clots, while antiplatelets stop platelets from making clots. Neither type can break up existing clots, but they can stop them from getting larger to prevent heart conditions such as heart attacks or strokes.

While these medicines might not cause a bruising problem, long-term use could result in easy bruising. However, be sure to consult a healthcare provider before stopping any medication.

Steroids

Asthma, COPD (chronic obstructive pulmonary disease), eczema, and rheumatoid arthritis are just some conditions with corticosteroids as a common treatment.

Taking corticosteroids has the potential to result in easy bruising. Whether someone is using an inhaler, taking pills, or applying a topical version of these powerful anti-inflammatory drugs, bruising is a common side effect—and long-term use may cause skin thinning.

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

Low Blood Platelet Count

If bruises seem to appear for no reason, a rare platelet disorder may be to blame. 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. Tell-tale signs that a person may have immune thrombocytopenia, a low platelet condition, might include purpura or petechiae (red spots under the skin that are small and flat). Both are considered to be types of bruising.

Of note, although it's uncommon, thrombocytopenia 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," said Dr. Ragni.

A Bleeding Disorder

Bruising in and of itself can be minor. But when it's accompanied by other symptoms, like nosebleeds, heavy periods, or excessive bleeding after surgery, something more than accidental bruising may be the issue.

"It's the company it keeps, the frequency that it occurs, even the severity by which it occurs," explained Dr. Ragni. Therefore, a bleeding disorder might be at play if abnormal bleeding patterns show up alongside easy bruising.

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

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

Liver Damage

Many things can cause liver damage, from hepatitis C infection to alcohol-related liver disease. With liver damage and disease, there may be fewer platelets circulating in your blood than you need for normal blood clotting, which can cause you to bruise easily, said Dr. Ragni. This can be the result of lower levels of hepatic-thrombopoietin (TPO).

What is TPO?

Thrombopoietin is a substance in the body, known as a cytokine, that regulates how platelets are produced.

It's also possible to have a liver disease and a bleeding disorder, so it's important to see a healthcare provider. "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," said Dr. Ragni.

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 may take longer than a week to go away, with new bruises showing up for three days.

How To Reduce Risks of Bruising

Minor bruises don't require treatment. But what about significant bruising due to, say, a fall, jam, or blow? Try the RICE method: rest, ice, compression, and elevation. In particular, you'll want to:

  • Apply ice for up to 15 minutes every hour
  • Keep the bruised area raised and rested
  • Take acetaminophen to reduce the pain

Of note, the RICE method is most beneficial for a fresh injury. "It may initially help a bruise from worsening, but it rarely has a benefit on a bruise after the first 24 hours," said Dr. Friedler. "After that time, heat can sometimes help the bruise clear up faster."

When To See a Healthcare Provider

There are some conditions where you'll want to seek medical attention for bruises, such as:

  • Large or multiple small bruises without a known injury
  • Bruising with signs of infection (e.g., oozing, a fever)
  • Bruises that don't look like they are healing or fading
  • Large or painful bruises following an injury
  • Increased and more frequent bruising
  • Bruises that appear following the use of a new medicine

Still, bruises usually go away on their own. However, if you're worried about them, consult a healthcare provider.

"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 Dr. Ragni.

A Quick Review

Bruising easily can be the result of a number of things, including being active, using certain treatments, or blood-related health conditions. Minor bruises can be treated with home remedies like ice and rest. However, for more serious issues or changes with bruises, you'll want to see a healthcare provider to find out what treatments may be best.

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