A bruise occurs when blood becomes trapped under the skin, usually due to an impact that damages a small blood vessel. A fall, bump, or anything else that puts sudden pressure on the skin can cause a bruise. Very hard blows can damage bones, causing deep bleeding and bruising that takes several weeks to heal. Minor bruises often heal in a few days.
Some people find that they get hurt so easily that they don’t remember the original cause. Others develop large bruises after minor injuries or find that their bruises take many weeks to heal. Easy bruising does not necessarily mean that a person has a medical condition, but a sudden change in the amount of bruising a person develops may warrant a conversation with a doctor. Any condition or medicine that increases bleeding can also make it easier for the person to hurt themselves.
Causes of easy bruising
People tend to bruise more easily as they age because blood vessels weaken and skin thins. Easy bruising can run in families too, so people whose family members get hurt easily may find that they do too. It can be difficult for a person to assess whether they bruise more than normal or bruise more easily than most other people. Some signs that a person is injured more easily than is typical include:
- Very large and painful bruises in response to minor injuries.
- Have a lot of bruises without remembering their cause.
- Bruises that often develop and take many weeks to heal.
- Bleeding for more than 10 minutes after an injury
Numerous medical conditions and lifestyle problems can make it easier for a person to get hurt. The most common include:
Medications that thin the blood can cause more bleeding and bruising in a person. Some popular blood thinners include:
Some other medications can weaken or change the behavior of blood vessels, worsen inflammation, or increase the risk of bleeding. They may include the following:
- Some herbal remedies, such as ginkgo biloba, ginseng, feverfew, large amounts of garlic, ginger, saw palmetto, and willow bark.
- Corticosteroids and glucocorticoids, for example prednisone.
- Certain antidepressants, such as citalopram and fluoxetine.
People taking medications who notice increased bleeding or bruising should see their doctor if their medication can cause bleeding. If this is the case, they can discuss with the doctor the risks and benefits of continuing the treatment.
Alcohol abuse and liver disease
Alcohol abuse is a key risk factor for liver diseases, such as cirrhosis. Cirrhosis and other liver diseases slowly undermine liver function. As liver disease progresses, the liver may stop making the proteins that help the blood to clot. As a result, a person can experience excessive bleeding and bruising easily. They can also be itchy, feel very tired or sick, and have swollen legs, dark urine, and yellow eyes or skin.
Liver disease is treatable, especially when diagnosed early by a doctor. People who drink should stop taking them immediately when they develop symptoms of liver health problems. A doctor can advise on the correct combination of medical treatments and lifestyle remedies.
Many genetic conditions can cause a person’s blood to clot slowly or not clot. Von Willebrand disease, the most common bleeding disorder, affects approximately 1% of the population. A person with this condition has a defective or absent von Willebrand protein, which is important for blood clotting. Treatment with synthetic hormones can improve blood clotting in people with von Willebrand disease. Hemophilia, another bleeding disorder, causes a factor VIII (hemophilia A) or factor IX (hemophilia B) missing or defective. Both proteins are important for blood clotting. Synthetic versions of these clotting factors can help treat hemophilia and reduce the risk of serious bleeding, including severe bruising.
When a genetic bleeding disorder bruises easily, it is also possible that the person may bleed excessively or even experience life-threatening bleeding. Symptoms do not appear suddenly. Instead, they are present from birth, which is why genetic bleeding disorders occur most often in infants and young children.
Certain vitamins allow the body to heal and the blood to clot. Deficiencies in vitamin C can cause a condition called scurvy. Scurvy causes bleeding gums, wounds that don’t heal, and 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 an injection of vitamin K at birth, babies can bruise easily or bleed excessively. Adults who are severely deficient in vitamin K may also notice a sudden increase in bruising.
Vitamin deficiencies are usually reasonably easy to correct. However, it is important for a doctor to diagnose these deficiencies with a blood test so that they can recommend the appropriate vitamin supplement. If vitamin supplements do not cure the problem, it may mean that a person has another problem, such as a metabolic or gastrointestinal disorder that makes it difficult for the body to absorb nutrients.
Vasculitis refers to a group of conditions that cause inflamed blood vessels. In addition to increased bleeding and bruising, a person may experience shortness of breath, numbness in the limbs and ulcers, bumps on the skin, or purple spots on the skin.
The type of treatment depends on the severity of the vasculitis and the area of the body it affects. Various medications, including steroids, can help.
Senile purpura generally affects older people, including about 10% of people over the age of 50. It causes purplish-red lesions like bruises on the skin and is more likely to affect the arms and hands.
In many cases, the lesions follow an injury to the skin. However, they last much longer than bruises and are usually much larger. Sometimes the skin remains brown even after the injury heals.
Protecting your skin from the sun can reduce the severity of symptoms. People with senile purpura should be aware of their bruises and try to protect their skin from injury. There is no cure, but a doctor can recommend lifestyle remedies to decrease the frequency and severity of injuries.
In rare cases, a sudden increase in bleeding, including bruising, can be a sign of cancer. Cancers that affect the blood and bone marrow, such as leukemia, can cause bruising. A person may also notice bleeding gums.
Many cancers are highly treatable, especially with an early diagnosis. People should never allow fear to delay treatment, but should see a doctor immediately. Chemotherapy, drugs, and surgery can save lives.