Why Am I Bruising So Easily?

Bruising easily is usually a problem with the container rather than the contents. Most people who bruise readily have perfectly normal blood; what has changed is the fragility of their small blood vessels and the padding of skin and fat around them, so ordinary knocks leak blood where they once would not.

That is why easy bruising becomes steadily more common after middle age, and why it shows up first on the forearms and shins, which take the most unnoticed contact and have the least protection.

What a bruise actually is#

A bruise is blood that has escaped from tiny vessels into the tissue underneath the skin. The color sequence, from red to purple to green to yellow, is hemoglobin being broken down and cleared over one to three weeks. Slow clearance makes old bruises linger, which many people read as new bruising when it is really old bruising fading late.

The causes worth knowing#

Age and sun damage. Long-term ultraviolet exposure thins the supportive collagen around small vessels. The classic result is flat purple patches on the backs of the hands and forearms that appear after trivial contact.

Medicines. Aspirin and other anti-inflammatories reduce platelet stickiness. Prescribed anticoagulants do so by design. Steroids, whether tablets or long-term high-dose inhalers, thin the skin. Several supplements, including fish oil, high-dose vitamin E and ginkgo, have a mild effect that adds up alongside the others.

Alcohol and liver health. The liver makes most clotting factors, so heavy alcohol use shows up as bruising well before anything else is obvious.

Nutrition. Genuine vitamin C deficiency is uncommon but still occurs in people with very restricted diets, and it causes fragile vessels and bleeding around hair follicles.

Blood disorders. Low platelets and clotting disorders are the least common causes but the most important not to miss. They rarely present as a few leg bruises; they present as many bruises at once, tiny red pinpoint spots that do not fade when pressed, and bleeding elsewhere.

What a doctor will check#

A full blood count is the single most useful test, because it shows platelet count, hemoglobin and white cells together. Depending on the story, a doctor may add clotting studies, liver function and ferritin. Unexplained bruising plus a normal full blood count is reassuring in most cases.

When to be seen quickly#

Bruises appearing with no injury at all, particularly on the trunk. Pinpoint red spots that do not blanch under pressure. Bruising with bleeding gums, repeated nosebleeds, or blood in urine or stool. New easy bruising alongside fever, night sweats or feeling profoundly unwell. Any of these justify a blood count within days rather than weeks.

The wider picture#

If you are trying to make sense of a blood count that has already been done, the fuller guide to reading your blood test results explains what platelets, hemoglobin and the rest of those numbers are actually telling you.