The Times Australia
The Times World News

.
The Times Real Estate

.

Why do I bruise so easily? Could it be something serious?

  • Written by Sant-Rayn Pasricha, Division Head, Population Health and Immunity, Walter and Eliza Hall Institute
Why do I bruise so easily? Could it be something serious?

After a bump, we can expect a bruise. But what if we find ourselves bruising without any noticeable cause? What might be behind it? Should we worry?

Around 18%[1] of adults report easy bruising. As haematologists (blood doctors), we are often asked for advice when people are worried they might bruise too easily.

Here is how we think about the problem.

What the blood does

Firstly, it helps to understand the complex, carefully balanced systems in our body that protect us from bleeding.

Blood flows as a liquid through our blood vessels, carrying red cells with their cargo of oxygen and immune cells to defend us from infections, to our brain, muscles and internal organs. Blood contains ingredients that are carefully balanced to protect us from bleeding if we are injured, while simultaneously minimising the risk of dangerous blood clot formation.

If a “puncture” occurs in a blood vessel, blood can rapidly thicken to form a jellylike clot, to minimise blood loss until the vessel repairs itself. To achieve this, tiny cell fragments called platelets[2] that circulate in the blood bind to the damaged blood vessel wall.

A host of proteins (clotting factors[3]), attracted by the platelets and damaged vessel wall, then combine to thicken the blood at the site and form a blood clot. Like all blood cells, platelets are made in the bone marrow, while clotting factors are mostly made in the liver.

So what can go wrong? If we have a problem affecting either our clotting factors, our platelets, or our blood vessel walls, we can find ourselves developing easy bruising or even problematic bleeding.

Read more: Hot pack or cold pack: which one to reach for when you're injured or in pain[4]

Could it be a problem?

In many patients who report easy bruising, haematologists can’t find any particular cause.

Blood doctors are usually more cautious when a person has a constellation of problems related to bleeding. For example, a disorder is more likely if the bruising is widespread with large bruises[5], is accompanied by frequent nosebleeds[6], heavy periods[7], problems with bleeding after major dental work, surgery or childbirth – or even spontaneous serious bleeding[8] into joints or into the brain.

A few simple tests can help us figure out if there is likely to be a serious problem.

The first we would perform for any person reporting easy bruising is a full blood count[9]. This will include a measurement of the platelet count and reliably show if the platelet numbers are normal.

Our platelets can be reduced for a number of reasons – either because they are not being produced in the bone marrow appropriately or in sufficient quantity, or because they are being removed from the circulation too quickly.

The latter scenario happens in a common condition called immune thrombocytopenic purpura[10]. This condition can affect children or adults out of the blue or following a viral infection. Patients can develop severe reductions in their platelet count and come out in a fine rash, which is actually small bruises.

In children, it is usually a short-term condition that recovers by itself. In adults, severe cases may need treatment with medicines that suppress the immune system or boost platelet production. Sometimes adults need surgery to remove the spleen.

gloved hand hold vial of blood
A full blood count is a good starting point for investigating the cause of easy bruising. Shutterstock[11]

Problems with clotting proteins and diseases

Clotting factors – the proteins mentioned earlier – can be affected by a range of inherited or acquired causes.

Some people are born with low levels of important factors that help the blood clot when it needs to control bleeding.

Haemophilia A[12] is seen almost exclusively in men and is caused by a genetic reduction in Factor VIII (a key clotting factor). Both men and women can have von Willebrand Disease[13], which involves reduced production or function of another key clotting factor.

Liver disease can also cause clotting problems. That’s why the second test we perform in any person reporting easy bruising is to measure clotting function. If we find an abnormality, we’ll follow up by testing the levels of key clotting factors.

Problems with blood vessels

Though rare today, severe vitamin C deficiency used to more commonly cause easy bruising and gum bleeding (“scurvy[14]”) and deficiencies[15] can still cause bruising.

Several diseases can cause blood vessel thinning or inflammation, including Henoch-Schonlein purpura[16] – an autoimmune condition that results in leg and thigh bruising.

Older people[17] can have fragile skin and blood vessels, making bruising more likely.

Hands in blue gloves examine arm showing bruising Doctors may do blood tests to rule out some causes of bruising. Shutterstock[18]

Read more: Why do we bleed? A hematologist explains how the body prevents blood loss after injury[19]

Medicines and supplements

We always ask patients about their medication and alternative medicine use.

Aspirin[20] – often prescribed to prevent platelets from worsening the risk of cardiac disease or stroke – can also reduce platelet function.

Medications like clopidogrel (to stop problem clotting) and non steroidal anti-inflammatory drugs (like ibuprofen or others taken for pain and inflammation) can reduce platelet function[21]. Blood thinners[22] such as warfarin, apixaban and rivaroxaban, prescribed to people with a higher risk of clots leading to stroke, can affect bruising.

People using oral or inhaled corticosteroids[23] for a prolonged period (such as for chronic illnesses) may notice increased bruising because of thinning of the skin and weakened blood vessel walls.

Over-the-counter supplements including gingko and vitamin E[24] can also promote easy bruising, as can some antidepressant[25] medications.

Read more: A history of blood clots is not usually any reason to avoid the AstraZeneca vaccine[26]

Questions of abuse and trauma

Finally, blood vessels can be damaged by trauma. Clinicians should carefully ask if the person has experienced any injuries, including a sensitive consideration[27] of child abuse or intimate partner violence.

While there are many medical conditions that can cause easy bruising, if you don’t have a strong history of other forms of excessive bleeding, and your blood counts and clotting function tests are normal, it shouldn’t be a cause for concern.

References

  1. ^ 18% (pubmed.ncbi.nlm.nih.gov)
  2. ^ platelets (www.redcrossblood.org)
  3. ^ clotting factors (www.ncbi.nlm.nih.gov)
  4. ^ Hot pack or cold pack: which one to reach for when you're injured or in pain (theconversation.com)
  5. ^ large bruises (www.webmd.com)
  6. ^ nosebleeds (my.clevelandclinic.org)
  7. ^ heavy periods (www.cdc.gov)
  8. ^ spontaneous serious bleeding (pubmed.ncbi.nlm.nih.gov)
  9. ^ full blood count (www.healthdirect.gov.au)
  10. ^ immune thrombocytopenic purpura (www.ncbi.nlm.nih.gov)
  11. ^ Shutterstock (www.shutterstock.com)
  12. ^ Haemophilia A (www.hemophilia.org)
  13. ^ von Willebrand Disease (www.cdc.gov)
  14. ^ scurvy (www.healthdirect.gov.au)
  15. ^ deficiencies (www.webmd.com)
  16. ^ Henoch-Schonlein purpura (www.rch.org.au)
  17. ^ Older people (www.healthline.com)
  18. ^ Shutterstock (www.shutterstock.com)
  19. ^ Why do we bleed? A hematologist explains how the body prevents blood loss after injury (theconversation.com)
  20. ^ Aspirin (www.nhs.uk)
  21. ^ reduce platelet function (www.uptodate.com)
  22. ^ Blood thinners (www.ahajournals.org)
  23. ^ corticosteroids (www.ncbi.nlm.nih.gov)
  24. ^ gingko and vitamin E (www.ncbi.nlm.nih.gov)
  25. ^ antidepressant (www.ncbi.nlm.nih.gov)
  26. ^ A history of blood clots is not usually any reason to avoid the AstraZeneca vaccine (theconversation.com)
  27. ^ consideration (www.aafp.org)

Read more https://theconversation.com/why-do-i-bruise-so-easily-could-it-be-something-serious-207736

The Times Features

Why Regional Small Businesses in Bendigo Deserve Better Access to Finance in 2025

In the heart of regional Victoria, Bendigo has long stood as a beacon of innovation, resilience and community spirit. As we step further into 2025, the importance of nurturing sm...

Is It Time for a Deep Cleaning? Signs You Shouldn’t Ignore

Most people know they should visit the dentist for a regular check-up and cleaning every six months. But sometimes, a standard cleaning isn’t enough. When plaque and tartar build...

The Hidden Meaning Behind Popular Engagement Ring Cuts

When it comes to engagement rings, the cut of the diamond is not just about aesthetics. Each shape carries its own symbolism and significance, making it an important decision for...

Annual Health Exams in the Office: How They Can Reduce Sick Days and Healthcare Costs

Regular health check-ups, especially annual health exams in the office, can significantly impact the overall well-being of your workforce. A proactive approach to employee health...

Best Deals on Home Furniture Online

Key Highlights Discover the best deals on high-quality outdoor furniture online. Transform your outdoor space into a stylish and comfortable oasis. Explore a wide range of d...

Discover the Best Women's Jumpers for Every Season

Key Highlights Explore lightweight jumpers for spring and summer, ensuring breathability and ease. Wrap up warm with cozy wool jumpers for the chilly autumn and winter season...

Times Magazine

The Essential Guide to Transforming Office Spaces for Maximum Efficiency

Why Office Fitouts MatterA well-designed office can make all the difference in productivity, employee satisfaction, and client impressions. Businesses of all sizes are investing in updated office spaces to create environments that foster collaborat...

The A/B Testing Revolution: How AI Optimized Landing Pages Without Human Input

A/B testing was always integral to the web-based marketing world. Was there a button that converted better? Marketing could pit one against the other and see which option worked better. This was always through human observation, and over time, as d...

Using Countdown Timers in Email: Do They Really Increase Conversions?

In a world that's always on, where marketers are attempting to entice a subscriber and get them to convert on the same screen with one email, the power of urgency is sometimes the essential element needed. One of the most popular ways to create urg...

Types of Software Consultants

In today's technology-driven world, businesses often seek the expertise of software consultants to navigate complex software needs. There are several types of software consultants, including solution architects, project managers, and user experienc...

CWU Assistive Tech Hub is Changing Lives: Win a Free Rollator Walker This Easter!

🌟 Mobility. Independence. Community. All in One. This Easter, the CWU Assistive Tech Hub is pleased to support the Banyule community by giving away a rollator walker. The giveaway will take place during the Macleod Village Easter Egg Hunt & Ma...

"Eternal Nurture" by Cara Barilla: A Timeless Collection of Wisdom and Healing

Renowned Sydney-born author and educator Cara Barilla has released her latest book, Eternal Nurture, a profound collection of inspirational quotes designed to support mindfulness, emotional healing, and personal growth. With a deep commitment to ...

LayBy Shopping