Bruising easily can be a result of normal aging, direct trauma or a birth mark, also known as a Mongolian spot. These situations do not indicate any serious health conditions and do not require treatment.
However, bruising easily may be a sign of immune thrombocytopenic purpura or hemophilia, which may be life-threatening and require treatment.
If you notice increased bruising, or if you bruise easily, you should see a doctor for assessment, especially if you have symptoms like bleeding gums, nosebleeds, excessive fatigue or joint pain. A dermatologist, family doctor or hematologist can confirm a diagnosis and initiate treatment as needed.
What causes easy bruising?
Bruising easily can occur due to:
1. Direct trauma
Direct trauma to the body can lead to purple bruises in the area. The force of trauma can rupture small blood vessels and lead to local bleeding, causing to dark bruising, pain, and swelling.
What to do: When purple bruising occurs due to trauma, no specific treatment is needed, as it will fade on its own with time. To speed-up recovery, you can apply a cold compress for 10 to 15 minutes per day. Check out other tips for getting rid of bruises at home.
It is common for structures that support the blood vessels to weaken with aging, which may make blood vessels more prone to rupture. This can lead to small micro-bleeds, which can be noted as bruising in the skin.
What to do: Generally, bruising from aging does not require treatment, as these bruises also fade on their own with time. Patients can be referred to a dermatologist or geriatric specialist, who may prescribe ointments to speed-up the fading of bruises. These ointments work by promoting the reabsorption of blood accumulated in the skin.
3. Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease in which the immune system targets cells that line the joints to attack and destroy them, as through these cells were foreign microorganisms. This immune response can lead to symptoms like joint pain that is symmetrical to both sides of the body, swelling and redness in one or more joints, and difficult moving the affected areas.
Rheumatoid arthritis is also associated with a low platelet count, which can lead to easy bruising. Although this relationship is not fully understood, platelets are thought to play a role in joint inflammation responses, and not just clotting and thrombosis processes.
What to do: Treatment for rheumatoid arthritis should be oriented by a rheumatologist. It normally includes the use of medications like anti-inflammatories, corticosteroids, immunosuppressants and biological agents, which are prescribed for flare-ups. Physiotherapy is also important for treatment and to prevent worsening.
4. Vitamin C deficiency
A vitamin C deficiency can also lead to easy bruising, as a lack of this vitamin can make small blood vessels more fragile. They are more prone to rupture and cause local micro-bleeds.
What to do: If a vitamin C deficiency has been confirmed, it is essential to increase your intake of vitamin C foods, like oranges, lemons, cherries, boiled broccoli and raw tomatoes. Check out a list of vitamin C foods to incorporate into your diet and see how to prepare them.
Foods that are rich in vitamin C help to stimulate collagen production, which promotes skin and blood vessel regeneration to prevent new bruising.
5. Immune thrombocytopenic purpura
Immune thrombocytopenic purpura (or ITP) is a condition characterized by a decreased platelet count due to an autoimmune response. Because platelets are destroyed, it is possible to notice several bruises on the skin.
What to do: Treatment of ITP should be oriented by a hematologist, who may prescribe medications to decrease immune system activity and/or medications to increase platelet production.
6. Thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura (or TTP) is a disorder in which there is a decreased amount of platelets as well as an abnormality in their functioning. This can happen due to a DNA mutation or a genetic mutation of an enzyme, which can lead to bruising, bleeding and intense abdominal pain.
What to do: Treatment for TTP should be initiated as soon as the first signs and symptoms emerge. The hematologist may order specific interventions, like plasmapheresis and medications, like corticosteroids and immunosuppressants.
Learn more about the different types of purpura and their symptoms.
Hemophilia is genetic disease in which there is a deficiency or decreased amount of certain coagulation factors. This can interfere with the clotting process and increase your risk for bleeding, leading to easy bruising. Other symptoms include joint pain and swelling, wounds that take long to heal, bleeding gums and nose bleeds for no apparent reason.
What to do: Treatment for hemophilia is done according to the plan established by a hematologist, which may involve injecting the lacking coagulation factors to support proper clotting processes.
8. Medication use
Some medications can interfere the body’s ability to clot or with platelet functioning, which increases the risk for bruising or ecchymosis. Some medications that can lead to bruising easily include aspirin, clopidogrel, acetaminophen, hydralazine, thiamine, chemotherapy and anticoagulant medication (e.g. heparin and rivaroxaban).
What to do: You should report bruising to your prescribed to assess the possibility or discontinuing it or swapping to another. If you are taking these medication, you should avoid risky situations that can increase bleeding, like contact sports.
Easy bruising in babies
Babies can be born with bruising that can range in color (e.g. gray or purple), size and areas found in the body. These are referred to as Mongolian spots and do not pose any health concerns or risks to the baby. They are also not a sign of trauma.
These spots generally disappear on their own within 2 years of age without any specific treatment. Some doctors may recommend exposing the spot to direct sun light for 15 minutes, before 10 am, when sun rays are weaker.
Bruises that appear after birth may be a result of direct trauma, capillary weakness or a coagulation disorder (although this is more rare). It is important to report bruising to a pediatrician for assessment.
If these bruises or spots emerge in large quantities, worsen throughout the day, or occur with other symptoms, like fever, bleeding or drowsiness, you should contact your pediatrician or proceed immediately to a pediatric urgent care center. The pediatrician will assess for the possibility of clotting disorders, platelet dysfunction and/or infections.