Why Do Some People Bruise So Easily?

Have you ever noticed a bruise and thought to yourself, “How did that get there? I don’t remember bumping into anything.” Since you’re reading this article, chances are the answer is “yes.” The good news? Those random bruises are rarely anything to worry about.

Bruises are common. In a study of 500 healthy adults in the U.S., about 1 in 5 reported easy bruising. Why is that?

We’ll cover common questions about bruising, including what’s normal and signs there may be an underlying issue. Keep on reading to learn tips to prevent bruises and when it’s time to talk to your healthcare provider.

What is a bruise?

Bruises are discolored areas that occur after trauma to the skin. Mild trauma, like bumping your arm on a table, can cause a bruise. More severe trauma, like a punch to the face (black eye), can cause bruising too. 

When skin is injured, tiny blood vessels (capillaries) break, and blood flows out of the broken vessels. It can get trapped underneath the skin or ooze out (bleeding). Blood trapped underneath the skin causes the color change people call a bruise. 

At first, bruises can be purple, black, or blue, depending on your skin tone. Then, the body sends in a sort of “stain-remover” team, and the color changes until it fades away. As the bruise heals, it might turn green, yellow, blue, light brown — or all of the above.

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Some bruises are painless, but many are tender. Some might even itch, especially if the skin is dry. Most bruises disappear within 2 weeks. If a bruise lasts longer than that, talk to your healthcare provider.

What causes bruising to happen more easily?

In order to understand why bruises happen more easily and more often in certain people, let’s talk a bit about skin. The skin is made up of three layers: 

• Epidermis (top layer)

• Dermis (middle layer)

• Subcutaneous fat (bottom layer)

Skin changes with age. The dermis becomes less flexible. Subcutaneous fat, which pads and protects small blood vessels underneath, thins out. And blood vessels underneath the subcutaneous fat become more fragile.  

These changes are more pronounced in people born with female anatomy, so women tend to bruise more easily than men. Sun damage from years of sun exposure can also speed up skin aging. 

Senile purpura (or actinic purpura) refers to bruising due to normal aging of skin. It affects over 10% of people older than 50 years old.  

Which medications can cause easy bruising?

Several common medications can play a role in easy bruising. Examples include:

• Antiplatelet medications, like aspirin and clopidogrel (Plavix)

• Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil) and naproxen (Aleve)

• Blood thinners, like warfarin

• Steroids, like prednisone

• Certain antidepressants, like Prozac (fluoxetine)

• Some dietary supplements, like turmeric and ginkgo

• Chemotherapy (can decrease platelets)

Which health conditions can cause easy bruising?

Though uncommon, a variety of health conditions can cause easy bruising. Most can be diagnosed with simple blood tests. For example:

• Severe vitamin deficiencies: Vitamin deficiencies, like low vitamin C or vitamin K, are rare in places where people have access to food that allows a balanced diet.

• Disorders that cause low platelets: Platelets are small blood cells that stop bleeding. When blood vessels break, platelets stick together to form a clot. Immune thrombocytopenia (ITP) is an example of a platelet disorder.

• Bleeding disorders: Many different proteins work with platelets to stop bleeding. Problems with any of these proteins can cause bruising. An example is von Willebrand disease.

• Severe liver disease (cirrhosis): Liver disease causes problems with platelets and the proteins that stop bleeding, which leads to bruising.

• Blood cancers: Blood cancers, like leukemia or lymphoma, may cause low platelet levels.

When should you see a provider about bruises?

If you’re worried about bruises, it’s always OK to reach out to a healthcare provider to ask questions. They will either reassure you that there’s nothing to worry about or suggest additional testing. If possible, take photos to share in case your bruises disappear before your appointment.

If your bruises occur with other symptoms, like an increase in bleeding, it’s a good idea to contact your healthcare provider. Examples include:

• Large and frequent bruises lasting longer than 2 to 3 weeks

• Frequent nosebleeds (more than five times a year)

• Longer or heavier than usual menstrual periods 

• Blood in the urine or stool

• Bloody gums every time you brush your teeth

• Yellowing of the skin (jaundice)

• Fatigue, weight loss, or fevers

If you have a family history of a bleeding disorder or platelet disorder, it’s also a good idea to let your provider know.

What can you do to prevent bruising?

When you’re busy, it’s easy to bump into things without noticing. But there are some things you can do to help:

• Eat a balanced diet.

• Talk to your healthcare provider about medications and dietary supplements that might lead to easy bruising.

• Wear sunscreen and avoid prolonged sun exposure.

• Decrease clutter around the house so there are fewer things to bump into.

Why trust our experts?

Written by:

Samantha C. Shapiro, MD

Samantha Shapiro, MD, is a board-certified rheumatologist and internist with expertise in autoimmune and inflammatory conditions. She founded the division of rheumatology at Dell Medical School at The University of Texas at Austin.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

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