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Bruises

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What Is a Bruise?

A bruise, also called a contusion (pronounced: kun-TOO-zhen), happens when a part of the body is injured and blood from the damaged capillaries (small blood vessels leaks out. With no place to go, the blood gets trapped under the skin, forming a red or purplish mark that’s tender when you touch it — a bruise.

Bruises can happen for many reasons, but most are the result of bumping and banging into things — or having things bump and bang into you. Fortunately, as anyone who’s ever sported a shiner knows, the mark isn’t permanent.

How Long Do Bruises Last?

Bruises usually fade away in about 2 weeks. Over that time, the bruise changes color as the body breaks down and reabsorbs the blood. The color of the bruise can give you an idea how old it is:

  • When you first get a bruise, it’s kind of reddish as the blood appears under the skin.
  • Within 1 or 2 days, the hemoglobin (an iron-containing substance that carries oxygen) in the blood changes and your bruise turns bluish-purple or even blackish.
  • After 5 to 10 days, the bruise turns greenish or yellowish.
  • Then, after 10 or 14 days, it turns yellowish-brown or light brown.

Finally, after about 2 weeks, your bruise fades away.

Who Gets Bruises?

Anyone can get a bruise. Some people bruise easily, while others don’t. Why? Bruising depends on several things, such as:

  • how tough the skin tissue is
  • whether someone has certain diseases or conditions
  • whether a person’s taking certain medications

Also, blood vessels tend to become fragile as people get older, which is why elderly people tend to bruise more easily.

How Can I Help Myself Feel Better?

Apply a cold compress to the bruise to help slow down the blood that’s flowing to the area, which decreases the amount of blood that ends up leaking into the tissues. It also helps keep the inflammation and swelling down. All you have to do is apply cold to the bruise for 15 to 20 minutes every hour for a day or two after the bruise appears.

You don’t need to buy a special cold pack, although they’re great to keep on hand in the freezer. Just get some ice, put it in a plastic bag, and wrap the bag in a cloth or a towel and place it on the bruise (don’t apply the ice directly to the skin).

Another trick is to use a bag of frozen vegetables. It doesn’t matter what kind — carrots, peas, lima beans, whatever — as long as they’re frozen. A bag of frozen vegetables is easy to apply to the bruise because it can form to the shape of the injured area. Also, like a cold pack, it can be used and refrozen again and again (just pick your least-favorite vegetables and label the bag — you don’t want to keep thawing and freezing veggies that you plan to eat!).

To reduce swelling and bruising, elevate the bruised area above the level of your heart. In other words, if the bruise is on your shin, lie down on a couch or bed and prop up your leg. This will help prevent blood from pooling in the area because more of the blood will flow back toward your heart. If you keep standing, more blood will flow to your bruised shin and the bruise will be larger.

Take acetaminophen for pain, if needed.

When Should I Call the Doctor?

Minor bruises are easily treated, but it’s probably best to talk to a doctor if:

  • A bruise isn’t improving after 2 weeks.
  • You bruise often and bruises seem to develop for no known reasons.
  • Your bruise is swelling and very painful.
  • You can’t move a joint or you think you may have a broken bone.
  • The bruise is near your eye and you have difficulty moving your eyes or seeing.

Can Bruises Be Prevented?

Bruises are kind of hard to avoid completely. But if you’re playing sports, riding your bike, inline skating, or doing anything where you might bump, bang, crash, or smash into something, it’s smart to wear protective gear like pads, shin guards, and helmets. Taking just a few extra seconds to put on that gear might save you from a couple of weeks of aches and pains.

Reviewed by: Mary L. Gavin, MD Date reviewed: August 2018

Do you ever feel like the main character in Hans Christian Andersen’s fairy tale “The Princess and the Pea,” in which the delicate princess wakes up “black and blue all over” after sleeping on a single pea covered by a tower of mattresses?

Your skin can reveal many clues about your health, so a tendency to bruise easily might make you worry.

Although finding frequent bruises can sometimes signal health problems, doctors say most cases are nothing to worry about.

Dr. Monique Tello, a primary care physician at Massachusetts General Hospital, encounters patients with “easy bruising anxiety” quite frequently.

“Thus far, in my ten years as an attending (physician), no one in my primary care practice has had any serious underlying condition,” Tello told TODAY. “Usually, they didn’t remember some bump, or were taking aspirin. Rarely, bruising can be a clue that there is a medical issue.”

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Most bruises happen when you suffer an injury that fails to break the skin, but crushes the small blood vessels underneath. Blood then leaks and becomes trapped under the surface, leaving the telltale mark.

If you work out a lot, you might notice bruising in fatty areas that are exposed, like your thighs, buttocks or legs, said Dr. Abigail Waldman, a dermatologist at Brigham and Women’s Hospital.

Here are other possible causes of easy bruising:

Blood thinners

Besides injury, blood thinners — medications or supplements that slow down or decrease your blood’s clotting ability — may be the number one cause for easy bruising, Waldman said. They’re very common, ranging from aspirin to drugs like Coumadin. If you’re on blood thinners, it may take longer for bleeding to stop, leading to bigger bruises.

You might not even realize you’re taking something that thins your blood: Fish oil supplements, ginkgo biloba, alcohol and garlic have similar effects.

Other drugs

Steroids can lead to thinner skin, so you may notice bruising with just slight trauma. Chemotherapy can lower the number of platelets — the cells that help your blood to clot — in your body, the National Cancer Institute notes. A low platelet count means a higher risk of bruising.

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Vitamin deficiency

Easy bruising might suggest you lack enough vitamin K, found in leafy green vegetables, broccoli, and Brussels sprouts. Most people get enough of this fat-soluble vitamin in their diets, so you don’t need to take a supplement, Waldman said. But if you are deficient, it’s a sign you may not absorbing vitamins correctly, she added. That may include people with Crohn’s disease or ulcerative colitis.

A severe lack of vitamin C — or scurvy — could also be the culprit because the vitamin is involved in building the walls of blood vessels, Waldman said. Scurvy is rare in the U.S. — symptoms include bleeding around hair follicles and bleeding gums.

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Aging

As you age, your blood vessels become more fragile. “You can think of it like a hose that holds the blood,” Waldman said. “As you get older, you sort of have some leaks in the hose. So very small injuries can cause that area to open up and leak blood out into the skin, causing a bruise.”

Older skin is more fragile, too, and there’s less fat underneath it, leaving you with less cushion if you bump into something. All of those factors can lead to senile purpura, or bruises that show up after very slight injury in elderly people. The marks typically appear in areas that have had significant sun exposure, like the arms and the hands, Waldman said

“Unfortunately, there’s not a lot you can do to prevent it, except to try to avoid any even minimal injury. But sometimes it’s nice for patients just to have a diagnosis,” she added.

Cancer

In rare cases, easy bruising can be a sign of blood, bone marrow or lymph node cancers, Waldman said. These marks often show up as petechiae — very small red dots from bleeding under the skin — but can look like large bruises as well.

The bruises can be one clue of many, so doctors will ask about any accompanying bleeding from the gums, fevers, chills, night sweats, bone pain, Tello said.

“In my years of training, I rotated through oncology and ICU units where patients had had easy bruising as one of many signs of their underlying leukemia or bleeding disorder diagnosis originally,” she noted.

Liver disease

The liver’s many functions include producing clotting factors. When the organ is damaged and slows or stops producing the proteins needed for blood clotting, you will bruise or bleed easily, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Genetic factors

The tendency to bruise easily can run in families. Genetic causes can lead to changes in your platelet count or the factors that are involved in clotting.

See a doctor if you have:

• Significant pain and swelling. That could represent a larger bleed under the skin, especially if you’ve had a significant fall or injury, Waldman said.

• A bruise that lasts longer than two weeks without changing. It may not be a bruise at all or be caused by an underlying problem.

• Small blood spots accompanied by fever, chills, weight loss or any other systemic symptoms that are new.

• Recurrent bruises without any clear causes.

There’s no one true definition of being an “easy bruiser,” but Waldman defines it as bruising with minimal or no injury. In most cases, bruises are not a cause for worry.

Putting ice on a bruise can help minimize swelling and some data suggests taking arnica orally can help prevent bruising, she noted. Your body will clear most bruises within a week.

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From the first inoculation to the inevitable fall from the playground swing, bruising informs our lives from an early age, a visible and painful reminder of the consequences of our – and others’ – actions.

A bruise, or contusion, appears when an injury causes tiny blood vessels called capillaries to burst and a small pool of blood is trapped below the skin.

Limit the bleeding by cooling the area with a cold compress such as a flannel or cloth soaked in cold water, or by holding an ice pack wrapped in a towel over the area for at least ten minutes.

Over-the-counter painkillers such as paracetamol or ibuprofen can help relieve the pain – although, ironically, blood-thinning anti-inflammatories such as ibuprofen can actually cause bruising in some patients.

After a day or two, the colour of the bruise changes to purple, blue or black, then green or yellow, and finally brownish yellow or light brown. In roughly two weeks, it should be healed and disappear altogether.

Why some people are more susceptible

So far, so prosaic. However, beyond everyday bumps, bruising may also indicative of other medical conditions – some benign, some more serious – and certain people are particularly susceptible.

It’s quite common for certain patients, especially women and the elderly, to bruise easily, but worry not; this doesn’t necessarily mean they are symptomatic of a more serious underlying problem.

Bruising may appear after intense exercise – for example, during or after heavy drinking, or as a result of sun damage, particularly on the backs of hands. In older patients, the skin becomes thinner and loses some of its protective fatty layer that helps cushion blood vessels from injury.

Bruises can also be caused by medications such as blood thinners and aspirin, both of which limit the ability of the blood to clot, resulting in more, often larger, contusions. Similarly, steroids cause your skin to thin, meaning blood vessels have less protection, and are more likely to break and bleed.

GP Dr Clare Morrison recommends checking your diet or taking a multivitamin, as a deficiency of certain vitamins – notably vitamins C, K and B12, as well as folic acid – may also be to blame.

In extreme cases, chronic vitamin C deficiency can cause scurvy. Long associated with the vegetable and fruit-starved diets of ancient pirates, surprisingly the disease still exists today.

In February of this year, a 39-year-old woman in the USA was (eventually) diagnosed with the disease. Bruising that refused to go away was the most salient symptom.

When should I worry about bruising?

Relatively rare, inherited clotting disorders such as haemophilia or von Willlebrand’s disease can also cause easy bruising from a young age.

Sufferers may experience excessive bleeding from small cuts, bleeding gums, nosebleeds and, in women, heavy periods, and may have relatives who are similarly affected.

“Sometimes the body doesn’t produce enough platelets in the blood, known as thrombocytopenia,” adds Morrison. “This can happen temporarily after a viral illness, with certain medications or during pregnancy. Occasionally, it is more serious and may require medical treatment.”

Rare conditions such as Cushing’s syndrome can also cause easy bruising due to an excess of the natural steroid cortisol in the body. Produced in the adrenal glands, the hormone regulates blood pressure and the cardiovascular system, converts nutrients into energy and plays a key role in your body’s response to stress.

“In addition to easy bruising, Cushing’s syndrome causes a round face, excessive fat around the abdomen and high blood pressure,” notes Morrison.

Bruising and cancer

On the darker side of the spectrum, cancers such as lymphoma or leukaemia (cancer of the blood), can cause easy bruising, in addition to tiredness, breathlessness, increased sweating and susceptibility to infections.

The latter reduces the body’s platelet count, making clotting more difficult.

“People with leukemia may bleed from their gums or noses, or may find blood in their stool or urine,” according to US medical centre the Cleveland Clinic. “Bruises may develop from very minor bumps. Small spots of discoloration – called petechiae – may form under the skin.”

“If in doubt, see your GP for a check-up,” advises Morrison. “They can examine you and arrange for blood tests if necessary, to rule out anything serious.”

Bruises don’t just happen under the skin, of course. Internal bruising can take place deeper in your tissues, organs and bones. While the bleeding isn’t visible, the bruises can cause swelling and pain.

Again, if you’re worried that you may have internal bruising from an injury or accident, visit your nearest accident and emergency (A&E) department, where a quick diagnosis can be made.

Bruising in leukaemia VS ordinary bruising

Although bruises from leukaemia are very similar to ordinary bruises, there are a few things you can look out for to help spot the difference:

  1. They occur in unusual places – In cases of leukaemia, quite often bruises will appear in places that you wouldn’t normally expect, especially; the back, legs, and hands.

For children, bruises may start to appear on the face, buttocks, ears, chest, and head.

“I noticed some unexplained bruises on my right hand and lower limbs.”

  1. There are lots of them – It is not unusual to have a few bruises on your body at once, especially if you are an active person. However, multiple bruises without explanation is a reason for concern.

“I counted 40 bruises on my body; I just thought I bruised easily.”

  1. You can’t explain why they are there – The bruises may appear without any clear reason. In other words, bruising without damage to that part of the body. They might also develop after very slight knocks that wouldn’t normally cause a bruise.

“I was bruising where I didn’t remember hitting myself.”

  1. They take longer than usual to disappear – Bruises may last for longer than you would expect or might continue to grow in size.

A normal bruise tends to heal after around two to four weeks. Therefore, if a bruise lasts for more than four weeks, we recommend getting it checked by your GP.

“The bruises tended to sort of keep on bleeding underneath the skin.

  1. You have been experiencing excess bleeding – Since bruising is a form of bleeding (it’s just underneath the skin), unusual bleeding from other areas of the body can also be a sign of leukaemia (e.g. heavy periods, frequent nosebleeds or bleeding gums).

“I was almost constantly bleeding from the mouth and the bruises were all over my body.”

Have you ever woken up and discovered that you have some new, mysterious bruise on your legs or arms? Well, there’s a simpler explanation than playing hockey in your sleep, and it’s all in how your skin is structured.

Some people, especially women, bruise easier than others. As dermatologist Dr. Joel Cohen explains over at Vice, this usually happens when a person has less collagen in their skin. Your skin has several layers that, among other things, protects the blood vessels underneath from damage. If you have a thinner layer of collagen, you can bruise more easily:

Collagen is “the main structural building block in the skin.” In the dermis, collagen forms a network of fibers that hold the rest of the skin together like a net. The collagen supports blood vessels so they are more protected from blunt force. Subcutaneous fat, on the other hand, does not structurally support the blood vessels—it’s padding. “It’s part of our buffer before we get down to the bone,” says Cohen. “It protects our bones and muscles from the outside world.”

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Bruises also show through more easily when you have a thinner layer of collagen. While it can vary from person to person, women tend towards having a thinner collagen layer than men, which can result in light bruises happening more frequently. While bigger bruises still mean bigger trauma and shouldn’t be ignored, light bruises can occur from even small bumps you’d otherwise ignore.

Why Women Bruise More Easily Than Men | Vice

Photo by Lindsey Turner.

19 Things People Who Wake Up With Bruises They Can’t Explain Know Well

Do you frequently wake up on weekend mornings with unexplainable bruises? Have these injuries started creeping into your week?

Do you find yourself having to explain, time and time again, little innocent mishaps that result in black and blues all over your body?

Do people seem overly concerned about your physical wellbeing?

Well, if you answered yes to these questions, just know you are far from alone. I would have to say a hefty portion of the population suffers from what I’m going to call “Random Bruising Syndrome (RBS).”

If the only bruises you sustain over the course of the week are results of drunken endeavors, consider that a f*cking accomplishment. Why? Because there are others who can’t even walk around their kitchen counters without banging their hips on the edge while dead sober.

The struggle is here, and today, we’re going to break it down for you, so you don’t feel so alone… and bruised.

1. You have anxiety because you don’t remember how you got injured.

Were you dancing on the bar again? Did you fall in your high heels? Did someone simply just bump into you?

You don’t even know why you’re asking yourself these questions because there’s no way in hell you’re going to be able to answer them.

2. You convince yourself you did more than you actually did while intoxicated.

Obviously your brain is on the fast track to the worst-case scenario because when you blacked out, what else are you supposed to think?

I mean, you did wake up with a dozen bruises, and you have no idea how you got them…

3. Your parents think you’re a sexual deviant.

That may be half true, but that’s not the reason for your bruises (at least most of them).

It’s really awkward during family dinner time, when you catch your parents eyeing your arms up and down, scanning for bruises.

4. You worry you’re anemic.

There must be a medical explanation as to why your skin looks like an expired banana.

It’s impossible that this sh*t happens for no reason. Hmm, but maybe the reason is that we’re uncoordinated and clumsy…

5. You have to plan your outfit around your bruises.

You can’t wear a short dress to work if you have bruises cascading up and down your legs now can you?

I guess you can, but that’ll get quite awkward when your boss asks you what’s up.

6. You have to awkwardly explain your predicament to your gyno and waxer.

Are you trying to convince them, or are you trying to convince yourself you don’t have a problem?

There is no non-awkward way to go about this, as these people are already looking at your naked body… there’s no hiding in these examination rooms.

7. People think you lead a more badass life than you do.

While being decked out in bruises gives you an air of reckless misery, people often draw the wrong conclusions about your lifestyle.

They think you rage 24/7, when in reality, it takes three of your friends to drag you out of bed on a Friday night…

8. You get them even when you’re not drunk.

The sad thing about your injuries is you sustain half of them while sober.

Actually, you probably get more when you’re sober, but you’re just so accustomed to it, it stops fazing you. Banging your elbow on a cabinet? Just your average Wednesday.

9. People think you get way drunker than you do.

Once your friends watch you take your first sip of alcohol, the tormenting can finally begin.

“How many bruises are you going to get tonight? I bet you end up dancing on a bar!!!”

10. Changing in the locker room is never an easy feat.

You thought your friends and parents’ judgments were harsh enough, that is, until you entered the women’s locker room.

Who knew strangers cared so much about the oddly placed contusions that span across your ass. Hmm, maybe it’s time to stop checking out our injuries in public mirrors.

11. Everyone just assumes you’re a hot mess.

Hey, at least they think you’re hot. It could be much, much worse.

12. You’re constantly reminded you can’t even walk.

You can’t even get over the embarrassment you felt when you tripped and fell on the sidewalk because your bruises are a constant reminder.

Unfortunately, they aren’t that great of reminders, or maybe we would finally learn our lesson.

13. You try and convince yourself it’s OK because it gives you street cred.

You know you respect someone with injuries because that means he or she can throw down in one way or another.

Secretly, you are just trying to convince yourself, but hey, it’s rationalization at its finest.

14. Falling upstairs is not a foreign occurrence to you.

In fact, it happens quite regularly.

15. You can never make anything look classy.

You are either tripping all over the place or your bruises are taking away the attention from whatever outfit you have on. There is just no winning when it comes to dressing…

16. When you’re pale, it’s just that much worse.

At least when you’re tan, your bruises blend in. When you’re pale, however, this is an entirely different story and struggle.

17. You never look healthy.

In fact, you look quite distraught… all of the damn time.

18. You don’t know what unblemished skin looks like.

That’s a thing? People actually have flawless skin? Get the f*ck out…

19. People think you have a more exciting sex life than you do.

You know what? There is no need to even try and argue this point. If it works in your advantage, why not go with it?

You’re undressing or showering and discover a bruise on your leg or arm. Baffled, you wonder: “Where did that come from? I don’t remember bumping into anything.”

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You may never pinpoint the source. The bruise eventually disappears, along with your concern. But bruising shouldn’t always be dismissed so easily, says hematologist Dana Angelini, MD.

“It’s common to bump into things, not remember, and see small bruises on your legs or arms,” she says. “However, unprovoked bruises on your torso, back or face are unusual. And that’s a reason to get them checked out.”

Here are other facts you should know about bruising:

How bruises develop

You may get a bruise from a bump or injury to the skin or the tissues beneath the skin. Since the skin isn’t cut or broken, you won’t see external bleeding. But damage to blood vessels below the skin causes them to rupture and leak blood.

Blood pooling and clotting beneath the surface causes skin discoloration. At first, the skin is often red or purplish. As the bruise heals, it may turn brown, green or yellow. The area often is swollen, tender or painful.

Why you bruise

Minor accidents — running into furniture, falling, dropping something on your leg, hand or foot — are the most common cause of bruising.

Certain medications make bruising more likely. Over-the-counter medicines such as aspirin, non-steroidal anti-inflammatory drugs (like ibuprofen), Plavix® (clopidogrel) and blood thinners (like Coumadin®) can increase your tendency to bruise. So can prescription medicines, such as certain antidepressants.

“Even over-the-counter supplements such as garlic, ginkgo, ginseng and fish oil can inhibit normal platelet function and cause bruising,” Dr. Angelini says.

Age is another factor. Older adults may bruise more easily than younger people. Their thinning skin often has less fat underneath to cushion the blood vessels.

Other possible causes of bruising include:

  • Deficiencies in Vitamin B12, Vitamin C or Vitamin K
  • Blood disorders such as Von Willebrand disease, hemophilia and platelet function defects or other blood clotting disorders
  • Domestic, child or elder abuse
  • Severe alcohol abuse
  • Malnutrition

When bruising is cause for concern

Bruises due to minor injuries or accidents usually disappear on their own after a week or two. During the healing process, the bruise will change color before fading away. But it’s a good idea to get a bruise checked out by your doctor if it:

  • Shows no signs of improvement after a week.
  • Is located on a part of your body where injury or accident is unlikely.
  • Keeps occurring or comes back.
  • Involves unusually large, unprovoked bruising

What to expect at the doctor’s

During an office visit, your doctor will review your family and personal medical history. You’ll answer questions like:

  • Do any family members have an inherited blood disorder?
  • Have you been bleeding from your nose or oral cavity?
  • Have any surgeries resulted in above-average bleeding?
  • Which medications and supplements do you take; have you recently started new ones?
  • If you’re a woman, has your menstrual flow been heavier?
  • Have you had other blood loss, such as in the urine or stool?
  • Have you ever had bleeding in unusual locations, like the joints, muscles or brain?

If your doctor decides medication is probably causing your bruising, he or she will discuss other options. “We’ll do a risk-benefit analysis,” Dr. Angelini says. “If life is going well, we might opt to keep you on the drug if it’s helping you control another disease.

“If the bruising is severe or interfering with your daily life, we’ll talk to the prescriber about replacing it with another medication.”

When the cause of bruising is unclear, your doctor will likely order blood work to check for platelet problems or other blood clotting abnormalities.

But don’t hesitate to ask your doctor for help. “We do a lot of consultations for bruising. When a serious bleeding disorder is ruled out, we’re happy to provide reassurance,” she says.

Why do some people bruise easily and when do you need to worry about it? An expert explains

We’ve all sported the odd black and blue mark from a knock, but for some of us, the slightest bump seems to result in a multi-coloured extravaganza, which might last as long as several weeks.

Other people might find they bruise a lot, even if the bruises themselves are not spectacular, but they cannot recall the impacts that would explain the marks.

So why do some people bruise more easily than others? And can it mean something sinister?

We bruise when something happens to break or burst the blood vessels that carry blood around our bodies.

Red blood cells leak out into the surrounding tissue, but they cannot survive outside the blood vessels so they pool in the flesh and start to break down.

This can result in a kaleidoscope of changing colours as the bruise progresses from black to brown to green to yellow.

It turns out there can be a number of explanations for bruising more easily. Here are some of the most common ones:

You’re a woman

Dr Andrew Miller, dermatologist and senior lecturer at ANU and a spokesman for the College of Dermatologists, said women tend to bruise more easily than men.

How to treat a bruise box

  • A decent deep bruise can take two to three weeks to go
  • While there are creams around that are supposed to reduce bruising, Dr Andrew Miller said “they probably don’t make a great deal of difference”
  • He suggests a cold pack and pressure to reduce the bleeding

Scientists do not know exactly why but it is probably to do with collagen (supporting tissue in the skin) and other factors such as skin thickness and subtle variations in the way blood vessels are supported.

We all have a fibrous matrix that holds our skin together and supports the blood vessels and the fine blood vessels.

Well-supported blood vessels are more tightly held in place and are therefore less likely to break and result in bruising when the skin is pushed or pulled.

While there are many factors that affect the firmness of the supportive matrix, it seems that men tend to have an overall advantage.

“The fibrous layer of the skin is thicker in men, as a rule, than it is in women. So they do have thicker skin,” Dr Miller said.

Getting older

As you get older, the firmness of the fibrous layer of your skin and the fat beneath it decreases.

Like many things as we age, it all starts to get a bit saggy and floppy.

This makes older people more vulnerable to bruising because the internal structure of their skin just is not as capable of holding the blood vessels firmly in place.

“When you bump against things, the skin moves more,” Dr Miller said.

“The shearing is greater and that results in more mechanical stress and more bruising.”

You’ve spent a lot of time in the sun

Unfortunately for sun-lovers (or those of us too old to have been protected by sunscreen), sun exposure really affects the firmness of the skin.

“The analogy I use to my patients is that the sun rots their skin, just like a piece of canvas,” Dr Miller said.

Bruising linked to sun damage is especially common on the forearms in men and women, and the lower legs in women (due to wearing dresses).

People who get big bruises with relatively little trauma… should probably speak to their doctor.

Dr Andrew Miller

Dr Miller said it is consistently the sun-exposed areas that are affected by easy bruising in older people.

“These same people, if they were to do the same relatively minor trauma on their trunk wouldn’t get a mark,” he said.

This bruising is often due to capillary bleeding, which results in the purple-black lesions that can cover the arms and legs of older people.

These bruises form easily and rapidly but take a long time to go, leading to an almost permanent accumulation of bruises.

You’re on certain medications

There are some medications that can have an effect on bruising.

Corticosteroids can cause an increase in easy bruising because they thin out the collagen in the skin.

Antiplatelet drugs (such as aspirin) and anticoagulant drugs (such as heparin or warfarin) can cause excessive bruising, which is when a really big bruise develops from a minor trauma.

“Antiplatelet drugs will interfere with clotting. That won’t necessarily make you bruise easily but you’ll bruise excessively,” Dr Miller said.

“So there has to be some sort of trauma there instead of ‘oh my goodness, I can’t remember anything to give myself that’.”

There are also some health conditions that result in easy or excessive bruising — these include leukaemia, haemophilia, Von Willebrand disease, Ehlers-Danlos Syndrome and a few others.

When do you need to worry about your bruising?

The main thing to look out for is when you sustain a big bruise for a relatively minor reason.

“People who get big bruises with relatively little trauma, then that is an indication that they should probably speak to their doctor about it,” Dr Miller said.

If worried about your bruising then speak to a health professional about it.

Why do some people bruise more easily than others?

When you think of bruising easily, your first thought might be Natasha Bedingfield’s Noughties ballad (undoubtedly a classic).

But what about the science behind it all? Some people bruise like a peach and can find themselves with blemishes after just brushing past a table, others can come out of a pretty nasty fall with no marks at all.

Dr Clare Morrison, medical adviser at MedExpress, says: “It’s quite common for patients to complain of bruising easily, particularly in women, and older people, and it doesn’t necessarily mean that there is anything wrong.”

So why do some people bruise more easily than others? Here are some explanations.

Medication

(Thinkstock/PA)

First things first: What are bruises? They’re the result of the blood vessels under the skin breaking or bursting. The blood leaks into the soft tissue of your skin, which is where the angry red colour comes from. Luckily, it fades to yellow and green colours over time.

Morrison says: “It’s often caused by medications, such as blood thinners, aspirin, steroids, or anti-inflammatories, such as ibuprofen.”

Blood thinners and anti-inflammatories affect how your platelets work – a part of the blood that helps it clot and stop flowing. Therefore if your blood capillaries burst, it might take a bit longer for the internal bleeding to stop, resulting in a bigger looking bruise.

Lifestyle

Your lifestyle can also affect how easily you bruise. Morrison says: “It can be seen after intense exercise, with heavy drinking, or with sun damage (particularly on the backs of hands).”

Let’s break this down – why would these seemingly unrelated factors contribute to bruising? Well, hardcore exercise can weaken your muscles and blood vessels, making it easier for them to burst. It also doesn’t help that if you’re running or cycling you’re more likely to accidentally bash your legs against some equipment.

If you’ve damaged your liver through heavy drinking, there are likely to be fewer platelets in your blood – which has the same effect on bruising as if you were taking blood thinners. And finally, sun damage can weaken blood vessel walls, making it more likely for them to burst.

Vitamins

bruises everywhereeee ☹️ i hereby promise to take my vitamins and sleep early…

— kay (@aguilarmykie) April 12, 2018

Morrison explains: “A lack of certain vitamins can cause easy bruising, notably vitamins C, K, and B12; and also folic acid.”

Vitamins like K help the blood coagulate, so it makes sense that it would affect bruising. Luckily, these things are easily fixed. “It’s worth checking your diet, or taking a multivitamin,” Morrison says.

Medical issues

Bruising is the 2nd most common symptom reported by all #leukaemia patients. If you’re experiencing unexplained bruising, see your GP > https://t.co/ZEfYPunysb pic.twitter.com/WSdCSKsG9v— Leukaemia Care (@LeukaemiaCareUK) February 10, 2018

However, there are also some deeper underlying medical issues that can make you more susceptible to bruising. Morrison says: “Some inherited clotting disorders such as haemophilia or Von Willebrand’s can also cause easy bruising from a young age. These people will probably also have problems with excessive bleeding, and may have affected relatives.”

Bruising is often linked to the amount of platelets in your blood. The condition of not having enough is called thrombocytopenia, and Morrison says: “This can happen temporarily after a viral illness, with certain medications or during pregnancy. Sometimes it’s more serious and needs medical treatment.”

She also says that some types of cancer (such as leukaemia, which affects your blood) can also contribute. Morrison adds: “Rare medical conditions such as Cushings syndrome can cause easy bruising. This is due to too much cortisol (natural steroid) in the body.”

Age

Older people tend to bruise more easily (Thinkstock/PA)

Older people tend to bruise more easily than their younger counterparts. The science behind this is pretty simple – as you get older, your skin and the blood vessels underneath become increasingly fragile and burst more easily.

Morrison says: “If in doubt, see your GP for a check-up. They can examine you and arrange for blood tests if necessary, to rule out anything serious.”

– Press Association

7 reasons why you bruise easily

Why do you bruise?

Bruising normally occurs when the tiny blood vessels under the surface of your skin are ruptured, usually by physical trauma or strain. Blood from the damaged blood cells collects under your skin resulting in discolouration, giving your bruise it’s atypical ‘black and blue’ appearance.

Fortunately, in most cases, bruises are usually caused by minor injuries – stubbing your toe, knocking your knee against a table etc., but occasionally you may notice bruises appearing on your skin and have no memory of how they originated.

Most of the time this can be brushed off as forgetfulness but nevertheless, some people are more susceptible to bruising than others – but why?

1. Your age

This is probably the most common and obvious reason as to why you are sporadically erupting in pink and purple contusions.

It’s unfortunate but it is a fact that as we age, certain changes do start take place within our body – our hair can fluctuate in colour, becoming weaker and more brittle; our bones start to lose their density and yes, we may start to notice the odd wrinkle appearing in the mirror. This is probably familiar to most of you and certainly won’t fill you with any enthusiasm but what you might be less aware of is the changes taking place when it comes to your skin.
Naturally, as you get older, your production of collagen will start to decrease. This is particularly important when you consider bruising, as collagen is an essential protein when it comes to your skin, keeping your dermis (the layer of skin under your epidermis) strong and supporting the growth of new skin cells.

When your production of collagen begins to decrease, your skin can become weaker and lose its elasticity, eventually leading to the formation of wrinkles. With your skin becoming frail and more penetrable, bruising will become inevitable as the rest of your body is now more vulnerable and less protected from physical trauma.

2. Your diet

Your age isn’t the only factor exposing you to bruising – surprisingly, your diet can also play a major role as well! This is usually due to your capillaries – those tiny blood vessels that are susceptible to rupturing under physical trauma.

If your blood vessels are weak or fragile then it only makes sense that bruising will be a more commonplace occurrence – but how does this factor in to your diet? Well some would argue that low levels of vitamin C can make your capillaries weaker.

This seems logical when you think about the role of vitamin C in your body: vitamin C helps to support your blood vessels and has even been linked to the synthesis of collagen.
The University of Michigan Health System certainly seems to share this opinion, stating that, “even minor deficiencies of vitamin C and possibly of flavonoids can lead to increased bruising. People who bruise easily may benefit from eating more fruits and vegetables, common sources of vitamin C and flavonoids.1”

There is even some research to support this idea as it was noted by the American Journal of Clinical Nutrition that some subjects with low levels of vitamin C appeared to notice lowered levels of bruising after they had upped their intake of this vital nutrient.2

1http://articles.mercola.com/sites/articles/archive/2015/05/11/bruising-easily.aspx#_edn5

2https://www.ncbi.nlm.nih.gov/pubmed/7015820

3. Your weight

This topic might seem to collude nicely with your diet and nutrition but the fact is that when you are obese or overweight, the ramifications for your health can be disastrous.

First let’s take a look at your blood pressure – hypertension is a real problem for those that are overweight. A diet that is chockfull of sugary snacks and refined fats is bound to send your blood pressure spiralling, which can have consequences for your blood vessels.

When blood is being pumped through the body too quickly or erratically, your blood vessels will eventually weaken, making them more susceptible to rupturing under force. An enlarged body mass can also place a strain on your blood vessels as well as other areas of your body, such as your circulatory system, which will struggle to keep up with your increasing demands.

4. Your alcohol consumption

Yes, booze can make you bruise more easily and not for the reasons you may be thinking. Yes, an unhappy collision with your neighbour’s dustbins or having a brawl with your now ex-best friend will certainly earn you some shiners in the morning but it’s not just a lack of judgement or coordination that alcohol is responsible for.

A persistent intake of alcohol can lower your levels of vitamin C which, as we have already discussed, is crucial for the health of your skin and blood vessels. Alcohol also carries an additional risk as it is known to be a ‘blood-thinner.’

Typical blood-thinners are usually types of medication prescribed to delay or prevent a blood clot – they work as their name might suggest, by thinning your blood and stopping your blood cells from sticking together. In the case of bruising, if your blood is unable to clot bruises will appear more easily and possibly take longer to heal.

5. Your medication

As we have mentioned, alcohol is a notable blood-thinner but quite possibly you are already thinning your blood in another form. When it comes to medication, there are two prominent types of blood-thinners; anticoagulant medicines and antiplatelet medicines.

Anticoagulants like warfarin and heparin are used to prevent blood clots – if you are on these types of medications, the chances are that your doctor has already explained the possible side-effects to you at length. However, what you may be unaware of is that over-the-counter aspirin is also a type of blood-thinner, working as an antiplatelet.

If you have any concerns about the medication that you have been prescribed, it is crucial that you speak to your GP as soon as possible.

6. Your levels of sun damage

When you think of sun-damaged skin, the image that pops into your head is likely angry red skin flaking down an unfortunate holidaymaker’s back.

Bruising is not a part of this picture and while it is true the immediate symptoms of sunburn need little explaining, the long-term repercussions are more insidious. If you are continually exposing your skin to the sun, not only are you risking skin cancer, you can also dramatically weaken your epidermal and dermal layers of skin.

If your skin is fragile and brittle, the tiny capillaries lurking just beneath the surface become more exposed to physical trauma and therefore burst easily when they come into contact with physical force, resulting in painful bruising and an increased recovery time.

7. Your genes

Finally, let’s talk about your genes. It’s no secret that what you inherit from your ancestors is responsible for almost every reaction that takes place within your body and bruising is no exception. For a start, your genes can determine your gender and unfortunately for women, this can matter when it comes to how easily you bruise.

Women do bruise a lot more easily than men because the structure of their blood vessels and the thickness of their skin are far different than that of a man. Women do not produce as much collagen and generally have a thinner epidermis, making them more susceptible to bruising.
Another factor you can thank your parents for is the colour of your hair. Interestingly enough though, research does suggest that individuals with red hair are more prone to bruising that those with dark brown or black hair – the evidence behind this is still inconclusive, especially since the study reported that “coagulation factor and platelet function test results were comparable in red-haired and dark-haired women,” suggesting that the underlying reason is still waiting to be discovered.3

3http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351323/

What you can do to help

The first thing you should do if you notice any unexplained bruises or contusions is consult your doctor. Although it’s unlikely, unexplained bruising has been linked to a number of more serious medical conditions, such as thrombocytopenia or even cancer!

If you have ascertained that your bruising is being caused by something minor or treatable, we’d recommend applying a cold compress to the affected area as soon as possible.

This should reduce any swelling and decrease blood flow to the area, curtailing any discolouration. You could also try keeping the affected area elevated as well – this will help to stop blood from pooling around your bruise, again easing any discolouration.

Once you have applied a cold compress and allowed time to benefit from the effects (usually 24 hours later) you could try applying some heat to improve your circulation. A warm compress or heating pad should do the trick!

My Top Tip:

Arnica Skin Cream contains fresh extracts of Arnica flowers, Comfrey and Chamomile. It is incredibly soothing for the skin and can be used when bumps and knocks leave the skin sore or bruised.

Arnica Skin Cream can be used as long as it is needed but be careful not to get it on any cuts or irritated skin.

“Excellent product, always like to have some in the house.”

Read what other people are saying about Arnica Skin Cream.

Causes of bruising easily

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