Bruising too easily: When is it a problem?

We’ve all had bruises — the breakage of small blood vessels below the surface of the skin. Normally, they can be attributed to bumping into your desk or running into a wall. However, nearly half of all people experience “easy bruising,” or bruising when there's no significant trauma.

If you’re experiencing bruising but you don’t remember physical trauma that caused it, here are some questions to ask yourself: 

How long have you noticed the bruising?

If you’ve suddenly started to bruise more easily, that could be a sign that something in your body has changed.

Where are the bruises located, and what are the sizes of the bruises?

Small bruises on the arms and legs or other extremities are likely to be from some kind of bump. Large bruises on the torso or other unusual places pose a more significant concern.

What medications are you taking?

Aspirin and blood thinners, such as Coumadin and Plavix, will increase the risk of bruising.

Is there a history of bleeding?

Easy bruising could reflect a bleeding disorder.

Have you had other signs of increased bleeding?

These signs could be nose bleeds or excessive bleeding after cuts. If you’re a woman, perhaps you experience excessive bleeding during periods.

Are you bleeding at unusual sites like muscles and joints?

This condition could be an indication of an underlying, inherited bleeding disorder.

Have you recently had a procedure that required a blood transfusion?

A need for blood transfusions may reflect excessive bleeding, especially if required after a procedure.

Are you anemic?

Anemia is red blood cell deficiency, and new anemia may be due to abnormal bleeding. Your physician will try to determine this.

If these questions didn’t reveal any concerns, then there’s likely not an underlying problem. Check in with your doctor periodically to make sure that nothing is changing. If there’s any evidence that an underlying condition could be causing bruising, you should see a hematologist to have your blood evaluated for clotting proteins.

Remember, easy bruising can occur naturally in some people and may not be connected to any medical problem. But if you experience excessive bruising, you should have a doctor evaluate you to rule out causes such as medication, illness and bleeding disorders.

Dr. Eric Kraut is a hematologist at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, where he treats bleeding and clotting disorders, sickle cell anemia, myeloproliferative disease, hairy cell leukemia and multiple myeloma.