Unexplained bruises

Dear Black and blue, 

While the possibility of bruising at some point in your life is almost unavoidable, seeing them out of the blue and consistently may be a cause for concern. Bruises usually occur when a significant force is put on the skin, injuring capillaries (tiny blood vessels in the body). The blood they carry then leaks out into the surrounding area and pools under the skin causing the often darkly pigmented spot that signifies a bruise. Platelets—small blood cells that help with clotting—eventually stop the bleeding and the body reabsorbs the leaked blood, allowing the bruise to heal. 

When bruising occurs easily, it may be an indicator of an underlying medical condition. It may be possible that your bruising could be caused by diabetes. One symptom of diabetes is poor circulation and nerve damage, which makes it harder for bruises and wounds to heal. However, it’s also possible that your most recent bruising may be linked to other age or medical-related issues such as: 

• Thinner or aging skin: 
  • Bruising may be more common in people over 65 years old because as people grow older, the skin naturally loses some of its fatty layer that protects blood vessels against damage. 
  • Chronic sun exposure can damage the skin and make it more fragile. A condition called Actinic purpura, which commonly affects older adults, is characterized by benign bruising on body parts most exposed to the sun such as the hands and arms. 
• Taking certain medications: 
  • Antiplatelet drugs (e.g., aspirin), anticoagulant drugs (e.g., warfarin), and nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen) affect blood clotting. If a blood vessel gets damaged, these drugs cause the platelets to take longer to stop the bleeding, resulting in a bruise. Certain antibiotics, antidepressants, and dietary supplements (e.g., Ginkgo biloba) may have similar effects. 
  • Other medications like corticosteroids that treat allergies, asthma, and eczema, may also make the skin thinner, making bruising easier. 
• Vitamin deficiencies: 
  • Vitamin C helps produce collagen, a protein that strengthens the walls of blood vessels, and vitamin K helps build proteins involved in blood clotting. Without enough of these vitamins, you may be more susceptible to bruising. 

In general, bruises often heal on their own within two weeks. However, if you’re experiencing persistent bruising, it’s recommended that you visit a health care provider. This is particularly important if these bruises have popped up with no explanation or are accompanied by painful swelling or unusual external bleeding. If these symptoms persist, it could point to more serious concerns, including: 

• A bleeding or clotting disorder 
• Alcohol abuse 
• Liver disease or cirrhosis 
• Anemia 
• Sepsis 
• Cancer 
• Physical abuse 

That said, you might also choose to try the following management and treatment methods in addition to visiting a health care provider: 

• Rest and elevate the injured area to prevent swelling and to relieve pain. 
• Apply ice packs for the first 24 to 48 hours after injury. Wrap the ice pack in a towel and apply for no more than 15 minutes at a time. Repeat throughout the day. 
• Apply a heating pad or warm compress to the injured area after two days. You can apply heat several times throughout the day. 

List adapted from The Cleveland Clinic 

While bruises may be a normal part of life, it’s important to keep an eye on them—kudos to you for being attentive to your body and concerns! 

Best wishes for being bruise-free,