Do You Bruise Easily? Causes and Prevention Techniques

Bruising easily is fairly common, and it may just be a sign of normal aging or because of a medicine you’re taking. But in some cases, easy bruising could be a cause for concern.

Everybody gets the occasional bruise on their arms or legs, and it’s normal not to remember the small injury that caused it. Bruises typically aren’t a big deal, and they usually go away within a week or so.

Most bruises happen when small blood vessels, called capillaries, near the surface of the skin are broken because of the impact of an injury — for example, bumping into a hard surface.

The broken blood vessels cause blood to pool under the skin, creating a mark that looks black and blue or red and purple and is often swollen or painful. Over the course of a few days, the bruise may turn green, brown, or yellow, which is a normal part of the healing process.

Easy bruising is defined as bruising without a history of trauma (like knocking into something) or after a minor bump that wouldn’t have caused bruising in the past.

Here’s what you need to know about easy bruising, what’s normal and what’s unusual, and when to see your healthcare provider to get it checked out.

Aging Process

A lifetime of sun damage contributes to easy bruising on areas that get a lot of sun exposure, such as the forearms, says Dana Angelini, MD, a hematologist at the Cleveland Clinic in Ohio.

Genetic Factors

Some people bruise easily because of mild bleeding disorders they’ve inherited, says Dr. Angelini.

“These conditions may not be noticeable in everyday life but can become problematic in situations where bleeding is a higher risk, such as surgery, childbirth, or injury. If you're prone to easy bruising, it's essential to know your family medical history, as many bleeding disorders are inherited,” says Angelini.

Von Willebrand disease is an example of this type of disease.

Nutritional Deficiencies

• Vitamin B12 deficiency can occur in people who aren’t eating food sources that contain the nutrient, such as meat, dairy, and eggs, or their body can’t absorb it properly.
• Vitamin C deficiency, or scurvy, usually only happens in severely malnourished people or those who are chronically ill.
• Vitamin K deficiency is more common in people with small intestine bacterial overgrowth (SIBO), celiac disease, chronic pancreatitis, inflammatory bowel disease (IBD), and alcohol misuse.

Medications and Supplements

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Over-the-counter drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve) can interfere with blood clotting, making you more likely to bruise.
• Anticoagulants (Blood Thinners) Warfarin, rivaroxaban, apixaban are used preventively to keep blood clots from forming. Because they slow down the clotting process, they also increase bleeding risk, including the close-to-the-skin bleeding that appears as a bruise.
• Antiplatelet Agents These drugs, including aspirin and clopidogrel, prevent blood cells (platelets) from sticking together and forming clots and can also lead to easier bleeding and bruising.
• Glucocorticoids (Steroids) Steroids, including prednisone and hydrocortisone, reduce inflammation and immune responses, but can also weaken blood vessels, making them more prone to damage.
• Dietary Supplements Ginkgo, vitamin E, and ginger supplements are associated with an increased risk of bruising.

Medical Conditions

Easy bruising can signal underlying health conditions, such as:

• Blood disorders or cancers: hemophilia, leukemia, and anemia

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• Low platelet count, called thrombocytopenia
• Liver diseases, which can be caused by viruses, alcohol misuse over time, liver cancer, and inherited diseases such as hemochromatosis and Wilson's disease

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• Certain autoimmune diseases and chronic conditions have easy bruising as a symptom. Some of the more common conditions include immune thrombocytopenia (ITP), lupus, Ehlers-Danlos syndrome, rheumatoid arthritis, and Cushing’s syndrome.

Most bruises go away on their own and don’t need treatment. More severe bruises might need treatment to relieve pain and make them go away faster.

These at-home treatments include:

• Rest and elevate the bruised area to prevent swelling and relieve pain.
• Apply ice packs for the first 24 to 48 hours after injury. Wrap the ice pack in a towel and apply ice for no more than 15 minutes at a time and repeat throughout the day.
• Use a heating pad or warm compress on the injured area after two days. Apply for 15 to 20 minutes at a time, and repeat as needed.
• Take over-the-counter pain relievers such as acetaminophen, but check with your provider before using NSAIDs.

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• Try a topical arnica product. Arnica is a plant often used in herbal and complementary medicine to relieve muscle pain, inflammation, and bruising. It’s generally safe when used on the skin (follow the instructions on the label), and there’s some evidence that it’s as effective as topical NSAIDs.

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• Bromelain supplements, made from enzymes found in pineapple, can reduce bruising and swelling when taken orally. They are sometimes recommended to people before they undergo cosmetic surgery that will cause bruising.

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“A lot of people think they bruise easily; that’s subjective and may or may not always be the case. It’s helpful when people take pictures of bruises they’re concerned about and make a note of the trauma that caused it,” says Angelini.

That way, even if the bruise has gone away by the time she sees them, they can still pull up the pictures, she says.

“I can look at it and confirm if it is a really big bruise considering what caused it,” says Angelini.

Certain types of bruising or bruising along with other symptoms may indicate a more serious underlying health issue and should be seen by a doctor.

Abnormal Bleeding If bruising is accompanied by unusual bleeding — like gum bleeding when brushing or flossing (if that doesn’t usually happen), frequent nosebleeds, or blood in the urine or stool — this, along with bruising, should be checked out by a doctor, says Angelini.

Large Unexplained Bruises Bruises with no identifiable cause that are on your torso, back, or face are unusual. A large bruise, especially one that appears without clear trauma, or if it seems much larger than expected from a minor bump, should raise concern. Smaller bruises (less than a quarter in size) probably don’t need to be checked out unless other symptoms accompany them, notes Angelini.

Unexplained Symptoms If bruising is accompanied by symptoms such as fatigue, swollen lymph nodes, night sweats, unexplained weight loss, or fever, these could be signs of a more serious condition and should be discussed with your provider, she says.

Bruises are a part of life, but there are ways to prevent injury and bruising.

Lifestyle and Dietary Adjustments

• Follow a balanced diet that includes plenty of fruits, vegetables, and essential nutrients.
• Engage in activities that improve your balance and strengthen your core.
• If you take supplements, review them with your doctor; some of them may be contributing to easy bruising, says Angelini.

Protective Measures

• Keep your floors clear of tripping hazards.
• Arrange furniture in a way that makes it easy to navigate a room without bumping into hard surfaces or corners.
• Wear helmets and pads when playing contact sports, skating, and skateboarding.
• Wear helmets and appropriate gear when bicycling or riding a motorcycle.

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Skin Care Tips

Limit sun exposure and use sunscreen to protect your skin, says Angelini.

• Easy bruising can be normal, especially with aging or with certain medications.
• Bruising without clear cause or with unusual symptoms such as abnormal bleeding, large unexplained bruises, or other concerning symptoms like fatigue or night sweats along with bruising should be checked out by a doctor.
• Stick to a balanced diet, protect your skin from sun damage, and review any supplements or medications with your healthcare provider to reduce the risk of bruising.