Easy bruising: Common as you age

Yet another bruise. What caused that dark, unsightly mark on your leg? You don't recall bumping into anything. Lately, however, you seem to be bruising frequently. Is this cause for concern?

Easy bruising is common with age. Although most bruises are harmless and go away without treatment, easy bruising can sometimes be a sign of a more serious problem.

Why is easy bruising so common in older adults?

Most bruises form when small blood vessels (capillaries) near the skin's surface are broken by the impact of a blow or injury — often on the arms or legs. When this happens, blood leaks out of the vessels and initially appears as a bright or dark red, purple or black mark. Eventually your body reabsorbs the blood, and the mark disappears.

Generally, harder blows cause larger bruises. However, if you bruise easily, a minor bump — one you might not even notice — can result in substantial discoloration.

Some people — especially women — are more prone to bruising than are others. As you get older, several factors can contribute to easy bruising, including:

Aging capillaries. Over time, the tissues supporting these vessels weaken, and capillary walls become more fragile and prone to rupture.
Thinning skin. With age, your skin becomes thinner and loses some of the protective fatty layer that helps cushion your blood vessels from injury. Excessive exposure to the sun accelerates this process.

Can medications and supplements contribute to easy bruising?

Blood-thinning drugs such as aspirin or medications such as clopidogrel (Plavix) reduce your blood's ability to clot. As a result, bleeding from capillary damage might take longer than usual to stop — which allows enough blood to leak out and cause a bruise.

Topical and systemic corticosteroids — which can be used to treat various conditions, including allergies, asthma and eczema — cause your skin to thin, making it easier to bruise. Certain dietary supplements, such as fish oil and ginkgo, also can increase your bruising risk due to a blood-thinning effect.

Don't stop taking your medications if you experience increased bruising. Consult your doctor about your concerns. In addition, make sure your doctor is aware of any supplements you're taking — especially if you're taking them while on a blood-thinning drug. Your doctor might recommend avoiding certain over-the-counter medications or supplements.

When does easy bruising indicate a more serious problem?

Easy bruising sometimes indicates a serious underlying condition, such as a blood-clotting problem or a blood disease. Consult your doctor if you:

Have unusually large or painful bruises, especially if your bruises seem to develop for no known reason
Have easy bruising and abnormal bleeding elsewhere, such as from your nose, gums or intestinal tract
Suddenly begin bruising, especially if you recently started a new medication
Develop bruising during an illness in addition to fever or confusion

These signs and symptoms can indicate low levels of or abnormally functioning platelets — components of blood that help it clot after an injury — or problems with proteins that help the blood clot. To diagnose the cause of your bruising, your doctor might check your blood platelet levels or do tests that measure the ability of your blood to clot.

Other serious causes of bruising include domestic violence or abuse. If a loved one has an unexplainable bruise, particularly in an unusual location such as around the eye or face, ask about the possibility of abuse.

How can I prevent or treat bruises?

To prevent minor bruising, eliminate household clutter that could cause bumps or falls. Long-sleeved shirts and pants can provide an extra layer of protection for your skin. Limit prolonged exposure to the sun to help you avoid its aging effects and a resulting increased risk of bruising.

Once a bruise has formed, however, not much can be done to treat it. Most bruises eventually disappear as your body reabsorbs the blood — although healing may take longer as you age. If the bruise is swollen, it might help to apply a cold compress and elevate the affected area. After the swelling decreases, a warm compress might speed removal of the blood. If the sight of a bruise bothers you, cover it with clothing or makeup.

You might not be able to eliminate easy bruising. However, taking simple steps to protect your skin and avoid injury can go a long way toward keeping you bruise-free.

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