Why Do I Bruise So Easily?

Laurie Saloman, M.S. | Jul 12th 2017 Jul 13th 2017

Reviewed by: John Edward Swartzberg, M.D.

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A common injury

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Do you feel as if you can’t bump against a piece of furniture without a black-and-blue mark appearing on your body? Do you notice an occasional bruise on an arm or a leg but don’t recall hurting yourself? Those types of bruises usually aren’t cause for concern. That’s because marks that appear on the hands, arms, and legs after bumping into objects or getting injured are common. You can speed healing and relieve pain by:

  • Applying firm, direct pressure to the area and holding for at least 5 minutes, which minimizes bleeding.
  • Elevating the area and applying a cold pack every hour or so for about 15 minutes for a day or two.
  • Taking acetaminophen instead of of nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen.

Here’s what else to know.

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Why you're black and blue

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A black-and-blue mark, medically called a contusion or an ecchymosis, is typically the result of a blunt impact that doesn’t break the skin but causes tiny blood vessels to break and leak blood into the surrounding tissues.

Your body responds to this with a variety of factors that cause clotting to halt the bleeding. You’re left with an unsightly and sometimes tender bruise. Over several days or a few weeks, white blood cells will consume the clot, causing your bruise to turn an array of colors, ranging from purplish to green to yellow, and then eventually fade away. Bruises can be attributed to several factors. Here are six.

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1. Thinner skin

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Older people bruise more easily than younger folks because their skin is thinner and less elastic, and they have less fat below the skin (called subcutaneous fat), so their blood vessels aren’t as well cushioned. The blood vessels themselves become more fragile and lose elasticity and thus are more vulnerable to tearing and rupturing.

Years of sun exposure also take their toll on exposed skin. Sustained pressure, as from a tight grip or even just a pinch, is often enough to bruise older people.

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2. Sun damage

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Harmless purplish bruises with small red patches affect people 65 and older. Called senile purpura, they often appear without any apparent knock or bang to the affected area and usually aren’t tender to the touch. Senile purpura tend to occur in areas of the skin damaged by the sun, predominantly the arms and the back of the hands. They often last longer than normal bruises and eventually fade to brown.

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3. Medications and supplements

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Certain drugs are associated with an increased risk of bruising. Primary culprits are anticoagulant medications, such as warfarin, which interfere with the blood’s clotting ability. Other drugs and supplements associated with easy bruising include nonsteroidal anti-inflammatory drugs (NSAIDs), which includes aspirin; corticosteroids, such as prednisone; ginkgo; ginger; and vitamin E.

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4. Fragile blood vessels

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This common form of easy bruising for no apparent reason, called purpura simplex, is characterized by fragile blood vessels. It appears most often on the thighs, buttocks, and upper arms and affects mostly women. Purpura simplex often runs in families.

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5. Poor nutrition

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Not getting enough vitamin C, vitamin K, or protein can make you more susceptible to easy bruising, although those deficiencies are extremely rare in the United States and more common in developing countries. Still, older people who are chronically ill, abuse alcohol, or have a gastrointestinal disorder that impairs absorption, such as celiac disease, inflammatory bowel disease, or chronic pancreatitis, are at increased risk for spontaneous bleeding.

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6. Blood spots

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Petechiae are tiny capillary hemorrhages, or broken blood vessels that bleed under the skin. They are less than 3 millimeters in size and tend to appear in groups. Purpura are larger purple patches (greater than 4 mm) that often appear on flat skin surfaces. The presence of petechiae or purpura for unexplained reasons may suggest a serious bleeding disorder, such as abnormally low platelets (thrombocytopenia). Other causes of petechiae and purpura include vasculitis (an inflamed blood vessel); liver disease; and sepsis, a serious systemic infection that requires immediate medical attention.

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When to see a doctor

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See your doctor about bruising if you:

  • Have five or more large bruises (greater than 1 centimeter in diameter) in areas of the body that typically wouldn’t be exposed to bumps.
  • Begin to bruise more frequently.
  • Have sudden, unexplained bleeding under the skin.
  • Notice blood spots (petechiae).
  • Have unexplained bruises after a recent medical procedure or surgery, including dental work.
  • Have a personal or family history of significant and unexpected bleeding, including after an injury or surgery, and bruises appear for no apparent reason.
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What your doctor will do

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Your doctor will examine you and ask about your medical history. If your doctor can’t immediately find a reason for your easy bruising, he or she may order blood tests or refer you to a hematologist, a doctor who specializes in blood disorders.