Easy Bruising
Everyone has experienced a bruise at some point. However, bruising that occurs easily—without injury or trauma—can be a sign of an underlying medical condition that is keeping your blood from clotting properly. It can also occur as a side effect of some medications, such as blood thinners.
This article will cover the symptoms, potential causes, and treatment for easy bruising.
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Symptoms of Easy Bruising
A bruise (contusion) is an area of skin that becomes discolored when blood vessels under the skin get damaged. Bruises commonly develop on the arms and legs, as these areas of the body are susceptible to injury (such as bumping into furniture). These bruises typically go away within one to two weeks.
Symptoms of easy bruising include:
Large bruises
Bruising without a known cause
Multiple bruises at the same time
Bruises on areas of the body not prone to injury (e.g., torso or face)
Causes of Easy Bruising
The most common cause of easy bruising is aging. Bruising can occur more easily as a person ages. The skin becomes thinner the older a person gets, making the blood vessels more prone to injury. Medications such as blood thinners can also result in easy bruising.
Frequent bruises can be a sign of physical abuse, whether in a child, adult, or older adult. The abuser may excuse the bruises by saying the person bruises easily, or the person may use that as an excuse so as not to admit they are being abused.
Easy bruising can be a sign of an underlying medical condition. All of these are rare:
Inherited bleeding disorders such as hemophilia or von Willebrands disease
Platelet disorders, including rare disorders and conditions such as leukemia that may result in low platelet numbers
Vitamin K deficiency
Cushing's syndrome
Vitamin K deficiency can lead to easy bruising. The vitamin plays an important role in blood clotting. A deficiency is rare, but it can occur in newborns, who are typically given a vitamin K injection at birth to prevent the deficiency. Other conditions in which a deficiency is seen include cystic fibrosis, ulcerative colitis, and after weight loss surgery (bariatric surgery).
Vitamin K is found in foods such as greens (spinach, kale, collards, etc.), soybeans, and organ meats. Supplements can also be a source of vitamin K.
One group of medical conditions that can cause easy bleeding are bleeding disorders. These conditions interfere with the body's ability to properly clot blood because there is a lack of proteins in the blood that help platelets form blood clots (clotting factors).
Symptoms of bleeding disorders can include:
Easy bruising
Heavy periods
Bleeding gums
Spontaneous nosebleeds
Bleeding into joints
Excessive bleeding from small injuries or after surgery
Hemophilia is a genetic condition that occurs when a person lacks specific clotting factors. There are two types of hemophilia: type A (which occurs when clotting factor VIII is lacking) and type B (which occurs when clotting factor IX is decreased).
The symptoms of hemophilia can be mild or severe, depending on how much clotting factor is present in the affected person's blood.
Von Willebrand disease is a bleeding disorder that occurs when a protein called von Willebrand factor in the blood is lacking or not working properly. This condition is more common than hemophilia and affects people of all sexes equally. There are three types of von Willebrand disease. Type 1 is the mildest, and type 3 is the most severe.
Easy bruising can be a symptom of Cushing's syndrome. In this condition, the body makes too much of a hormone called cortisol. Cushing's is most often caused by long-term use of corticosteroid medications, but it can also be caused by a tumor.
Other symptoms of Cushing's include:
Rounded face
Weight gain
Stretch marks
Muscle weakness
Fat in the base of the neck
Thin arms and legs
There are several types of platelet disorders and conditions that lead to low numbers of platelets or platelets that don't function well, resulting in reduced clotting and easy bruising. Leukemia is a type of cancer that affects blood cells. It can cause low platelet levels, which can lead to easy bruising. Other symptoms of leukemia include:
Joint pain
Night sweats
Loss of appetite
Unexplained weight loss
Difficulty breathing
Swollen lymph nodes
Fever
Fatigue
Prolonged bleeding
Medications That Can Cause Easy Bruising
Easy bruising can be a side effect of certain medications, such as:
Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications decrease inflammation and pain. Examples of NSAIDs include Advil or Motrin (ibuprofen), Bayer (aspirin), and Aleve (naproxen).
Blood thinners: These medications help prevent blood clots that can lead to stroke, heart attack, and pulmonary embolism. Coumadin (warfarin) is a commonly prescribed blood thinner.
Chemotherapy: Chemotherapy for cancer inhibits actively dividing cells, including those in the bone marrow that produce platelets. This can lead to a low platelet count and easy bruising.
If you are experiencing easy bruising as a side effect of medication, do not stop taking it without talking to your provider. In some cases, the risks of not taking your medication are more serious than the side effects it causes.
How to Treat Easy Bruising
Bruises typically will heal without specific treatment.
You might take steps to prevent falls and remove hazards that cause a bruise. Look for tripping hazards in your home, such as clutter, throw rugs, and electrical cords. Arrange the furniture so you are less likely to bump into it.
Ensure your home is well-lit, and turn on the lights before you move about. Have your eyesight and hearing checked so you are more aware of your environment.
If a medication is the likely cause of easy bruising, a healthcare provider will discuss its benefits versus risks. Do not stop a medication or change its dosage except under the advice of a healthcare provider.
Treatment for inherited bleeding disorders, Cushing disease, and platelet disorders will depend on the underlying cause.
Treatment for bleeding disorders depends on the severity of the condition. Mild cases might only need treatment during procedures, such as dental work or during childbirth when bleeding is likely to occur. In these situations, medications called antifibrinolytic agents can be taken to help control bleeding.
A synthetic hormone called Ddavp (Desmopressin) is used to treat minor bleeding. Birth control pills can help control the amount of bleeding during menstrual periods. More serious cases of bleeding disorders might require factor replacement therapy that adds clotting factors to the blood.
Leukemia can be treated with chemotherapy or other medications, radiation, and stem cell transplant. The treatment for Cushing's syndrome will be specific to the underlying cause but can include medication, chemotherapy, radiation, or sometimes surgery.
Are There Tests to Diagnose the Cause of Easy Bruising?
A healthcare provider will review your symptoms, medical history, and list of medications. They will conduct a physical examination.
Bleeding disorders and platelet disorders are diagnosed by reviewing your symptoms and performing blood tests. These tests can include:
Complete blood count (CBC): Determines the number of blood cells and platelets in your blood
Prothrombin time (PT): Measures how long it takes for your blood to clot
Clotting factor tests: Assess amounts of different clotting factors in your blood
Genetic testing: Looks for genetic defects that occur with bleeding and platelet disorders
Leukemia is diagnosed with blood and bone marrow tests.
Cushing's syndrome is diagnosed with blood, urine, and saliva tests, as well as imaging to identify tumors.
When to See a Healthcare Provider
Talk to a healthcare provider if you notice frequent bruising—especially if there doesn't appear to be an obvious cause. Other signs that you should get treatment for easy bruising include:
Frequent nosebleeds
Bleeding that does not stop after 10 minutes
Having periods that last more than seven days
Heavy periods that require changing a pad or tampon more frequently than every two hours
Family history of bleeding disorders
Summary
Easy bruising can cause large bruises in multiple areas of the body, often at the same time. The most common cause is aging or the side effect of medications such as blood thinners or chemotherapy. The discolorations can be caused by rare bleeding disorders or other rare medical conditions. Frequent bruising may also be a sign of physical abuse.
Bleeding disorders are genetic conditions that are diagnosed with blood tests. In addition to easy bruising, bleeding disorders can cause frequent nosebleeds, heavy periods, and bleeding that does not stop after 10 minutes. Other medical conditions that can cause easy bruising include Cushing's syndrome and leukemia.
Frequently Asked Questions
How do I know if I have easy bruising?
People who bruise easily often have multiple large bruises on their bodies at the same time. Easy bruising can occur along with other symptoms, such as frequent nosebleeds or heavy periods, depending on the underlying cause.
How is easy bruising treated?
Treatment for easy bruising depends on the cause. Sometimes, easy bruising is a side effect of medication. In this case, your provider might be able to change your medication. Easy bruising that's caused by bleeding disorders can be treated with medication.
