Bruising

Everyone gets bruises (ecchymosis) from time to time, especially if you have a medical condition that makes bruising more likely.¹ Or if you play sports a lot, in which case you may be all too familiar with having bruised ribs, bruised toes, a bruised tailbone… and so on. … Read More See less

Most of the time, bruising is nothing to worry about. It might look unsightly, and it may cause some pain and discomfort, but generally, if you leave it alone it’ll get better without any intervention.¹

However, bruising can sometimes be a sign of an underlying health condition.¹ So, it’s important to pay attention to bruising and have an awareness of when it’s time to speak to your GP about bruising.

If you’re wondering “why do I bruise so easily?”, you’ve come to the right place. Keep reading to find out everything you need to know about bruising.

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What is bruising?

Bruising is the skin discolouration caused when your small blood vessels (capillaries; the tubes that carry your blood through your body) break, due to impact or injury, and bleed.^1–4

If there isn’t an opening for your blood to leak out from, it pools underneath your skin and creates a bruise.^1,2 Your blood cells (platelets) then work to repair the leak in your blood vessels and heal your bruise.¹

There are three kinds of bruises:⁵

Subcutaneous – just under the skin
Intramuscular – within the muscle under the skin
Periosteal – a bone bruise (the most painful kind of bruise)

However, not all bleeding underneath the skin causes a bruise: ^1,4,5

Petechiae – bleeding from broken blood vessels can lead to tiny purple dots on your skin
Purpura – in between petechiae and ecchymosis in terms of size, purpura are small patches of skin discolouration caused by bleeding under the skin
Hematoma – a significant trauma, such as a car accident, can cause a collection of blood outside your blood vessels that’s larger than ecchymosis, raised and painful to touch

Bruising symptoms

Depending on the cause and location, bruises can vary in size, shape and colour.¹ The symptoms of bruising include:^1,3–6

A patch of skin discoloration that transitions during the stages of bruising from red, purple, black or brown (depending on the colour of your skin) to blue, green or yellow
Pain or tenderness when you touch the affected area
Swelling or a raised bump on your skin

Importantly, people with darker skin tend to have darker bruises, which can be more difficult to see.⁶ Additionally, people born female may get random bruises on their legs, because females tend to bruise more easily than males.⁶

What causes bruises?

Your blood vessels can break and bleed due to:^1,2,4,5,8

An injury or physical trauma to your body
Aging skin, due to reduced skin thickness
Medications that reduce your blood’s ability to clot, such as ibuprofen, naproxen, aspirin and warfarin
Medical treatments, such as radiation and chemotherapy, as these lower the number of platelets in your blood
Certain medical conditions

When is bruising a sign of something more serious?

If you’re experiencing bruising that isn’t directly related an injury or trauma, it could be a sign of an underlying medical condition:^6,9,10–27

Vascular disorders

Hereditary haemorrhagic telangiectasia – a rare, inherited genetic disorder that results in underdeveloped blood vessels that can easily bleed
Ehlers-danlos syndrome – a rare, inherited condition that affects the connective tissues. It causes bruising due to fragile capillaries and poor structural integrity of the skin
Osteogenesis imperfecta (brittle bone disease) – an inherited bone disorder that can cause bruising, potentially due to defective collagen in small blood vessels
Vitamin c deficiency (scurvy) – you need vitamin c for your blood vessels to function properly

Platelet disorders

Thrombocytopenia – a rare blood disorder that prevents your blood from clotting properly due to a low platelet count
Leukaemia – a cancer of the blood that causes leukaemia bruises due to a deficiency of healthy blood cells
End-stage chronic kidney disease – when the kidneys don’t work as well as they should. In the end stages, this can cause bruising due to platelet abnormalities
Liver disease – a number of conditions that result from damage to your liver and can cause platelet abnormalities

Coagulations disorders

Haemophilia A and haemophilia B – a rare, inherited condition that prevents your blood from clotting properly, meaning you bleed more easily than other people
Vitamin K deficiency – vitamin K helps your blood to clot so that wounds can heal properly
Von Willebrand disease – the most common inherited condition that prevents your blood from clotting properly
Amyloidosis – a group of rare conditions caused by a build-up of a protein called amyloid in your body which can make your blood vessels more fragile

How to treat bruising

If you’re wondering how to remove bruises, most bruises do not need treatment and will fade on their own within around two weeks.¹ You can help your bruises heal more quickly by:^1,3,5,28

Elevating the bruise above heart level, if possible, to prevent blood from pooling
Applying an ice pack wrapped in a towel for 15–20 minutes for the first 24 to 48 hours after injury, to reduce swelling
Resting the affected body part to prevent overworking your muscles
Using heparinoid bruise cream to reduce swelling
Taking paracetamol to reduce your pain

However, if you experience frequent, unexplained, large bruises that last for more than two weeks, you should speak to your GP.¹ They may decide to do some tests to check whether these are a sign of an underlying condition.¹Tests may include:¹