Why do I bruise so easily?

IF you’re more prone to bruising than the next person, you’ve likely asked yourself – why?

Bruising is a natural response to a bump or fall here and there, and occurs when blood gets trapped under the skin.

Sometimes people bruise more easily as a result of genetics. It can run in families – so if your relatives often get them, you might do, too.

Dr Emma Wedgeworth, Consultant Dermatologist and British Skin Foundation spokesperson, said: “Whilst some easy bruising can be explained by medication or underlying medical conditions, even amongst healthy people, some people just seem to be more prone to bruises than others.

“Although we don’t completely understand why some people bruise so easily, there are some clues.

“Bruises tend to more obvious on lighter skin tones with less melanin pigment. In addition, women tend to bruise more easily than men – this may be due to slight structural differences in women’s collagen, blood vessels and fat layers.”

If you’ve always noticed you come up in bruises more easily, there isn’t much you can do to prevent it.

Although there are “old wives tales” that help speed up its recovery, including banana skin and an ice pack.

But there are more complicated reasons at the root cause, some of which may need medical attention.

Some of the less concerning causes of bruising are related to:

Age

As we get older, our skin becomes thinner and our blood vessels weaker.

The tissues that support the blood vessels also become more fragile.

These things together mean you may notice yourself, or a loved one, showing up in more purple shiners, sometimes without memory of where they come from.

Medication 

There are a number of medicines with side effects of bruising.

Most often they are those which reduce the blood’s ability to clot, such as blood thinners (warfarin and heparin, for example).

Many drugs to treat cancer can lower platelets in the blood, leading to bleeding. This may lead to a condition called thrombocytopenia, which shows as tiny purple or red dots on the skin. 

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can increase bruising, as well as steroids like prednisone and antidepressants. 

Read the packaging of your prescription drug to find out more, or ask your doctor.

Some of the more concerning causes of bruising are:

Drinking too much

One of the main functions of the liver is to produce chemicals known as clotting factors.

These are what produce normal blood coagulation, while the organ also helps blood move evenly throughout the body.

So if you drink too much alcohol, and have damaged the liver, one of the first signs may be easier bruising.

Bleeding disorder

There are a range of bleeding disorders, of which bruising is a symptom, which affect a small number of people.

Von Willebrand disease is the most prevalent bleeding disorder and is diagnosed in about one per cent of the population.

Along with bruising, the condition can cause bleeding glubs, heavy periods and nosebleeds.

Haemophilia is a genetic condition that prevents the blood from properly clotting, and can be mild or severe.

The main symptoms is bleeding that does not, after a minor injury for example. But it can also cause easily bruised skin. 

These conditions can be treated with medicines. But patients are at risk of severe and potentially life-threatening hemorrhages. 

Low blood platelets 

Platelets help the blood clot, so without them, bleeding can’t stop.

Thrombocytopenia, characteristed by bruising, pin-point dots on the skin, bleeding from the nose, gums or in stool, is when someone’s body doesn’t produce enough platelets.

It’s not very often inherited, and instead brought on by things like a bacterial infection, pregnancy, autoimmune conditions, a virus or medication. 

For example, health regulators have warned to look out for unusual bruising, a headache and chest pain, among other symptoms, after the AstraZeneca Covid vaccine.

Cancer

Aside from the treatment given for cancer, the disease itself can also make someone susceptible to bruising.

Easily bruising and bleeding is the fourth most common leukaemia symptom, according to Leukaemia Care, occurring because there is a deficiency in healthy blood cells in the bone marrow.

The charity says spotting this type of bruising could be the key to an early diagnosis. 

They occur in unusual places, like the back of the legs and hands, there are lots of them for no apparent reason, they take longer to go away and may get larger. 

Lymphoma cancer can also cause the body to destroy blood cells, leading to bruising, frequent infections and fatigue.

Internal bleeding

Sometimes what looks like “bruising” could actually be internal bleeding – and you need to get to an A&E fast.

Internal bleeding is often the result of an injury or trauma, such as after a car accident, so it’s likely you’ll already be in doctors’ hands.

But most of the time, internal bleeding is impossible to see.

For example it could be in your head, causing weakness, loss of balance or consciousness, or in your chest or stomach, causing pain and shortness of breath.