The running joke is that you’re a klutz with a capital K—the bull in a china shop who can’t stay upright or keep out of the path of, well, everything. That’s the easy answer for those gnarly bruises you sport so often they seem like tattoos snaking their way around your limbs. But sometimes you wonder if something more sinister is at play. Why do you bruise so easily—and does it mean there’s actually something wrong?
What causes bruises to form
Most nerves and blood vessels are located in the dermis, the layer of skin underneath the epidermis. About 80 percent of the dermis is collagen, a structural protein that gives skin its strength and helps make it elastic, so it can stretch and bounce back, says Jules Lipoff, an assistant professor of dermatology at the University of Pennsylvania. Collagen fibers protect the integrity of the skin and blood vessels, so if something weakens the collagen—or if you just had weaker collagen to begin with—you might be more prone to bruising, Lipoff says. When a blood vessel is damaged, it can rupture and leak blood, causing a bruise.
So the first reason some people might bruise more easily than others is the most obvious—some people simply have weak collagen or fragile blood vessels, says Adam Friedman, an associate professor of dermatology at The George Washington University School of Medicine & Health Science. In other words, it’s in their genes.
What makes some people more prone to bruising
But there are a number of other factors that can also screw with collagen production and leave you more prone to bruising. One could be the amount of time you spend in the sun: When chronic sun exposure weakens the skin, it takes very little contact for blood vessels to leak, Lipoff says. This can lead to a condition called solar purpura—a fancy word for purple spots that resemble bruises and don’t blanch or go away, Lipoff says. So if you can’t remember bumping into anything, it’s possible you didn’t. Solar purpura is most common among the elderly, but not unheard of among young people, according to a 2017 article in the Journal of Clinical and Aesthetic Dermatology.
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Medication can also increase sensitivity to bruising. Oral and topical steroids like prednisone, NSAIDs like ibuprofen, and blood thinners can weaken support structures around the blood vessels, Friedman says. Additionally, some OTC supplements such as ginkgo and fish oil can interfere with platelet functioning, which increases sensitivity to bruises.
Finally, as with most things, nutrition plays a role—particularly the amount of vitamin C in your diet. Vitamin C deficiencies are rare, but your doctor might suggest running a test to make sure your levels are normal, Lipoff says, adding that the same goes for zinc, as well as vitamins B12 and K. You might also want to be mindful of whether bruises are popping up after particularly grueling workouts. Some types of vigorous exercise—like weight lifting—can create tiny tears in muscle fibers, causing bleeding, which leads to bruises.
That said, being highly prone to bruises isn’t usually a reason to freak out—they often look worse than they actually are , Friedman says. If you’re worried, the first question you should ask is whether or not your bruise occurs alone or with some other symptom. If it’s just the bruising, it’s probably harmless—annoying, maybe, but no big deal. But if easy bruising happens in tandem with joint pain, dramatic weight loss, or night sweats, for instance, there might be something going on that’s beyond skin deep, Friedman says.
What to do if you bruise easily
Pay attention to bruises that don’t go away after three to four weeks, since most tend to disappear within two weeks. It’s also worth flagging recurring bruises in unusual places, such as your back and torso. Bruising on the trunk is more likely to indicate a bleeding disorder than bruising on the limbs, according to an article published in the British Medical Journal. While it’s rare, roughly one to two percent of people has von Willebrand disease, a genetic disorder caused by missing clotting proteins, the authors note, which is treatable. Because the symptoms can be so mild, the disorder can be difficult to diagnose. Women, for example, typically notice six bleeding-related problems before they’re diagnosed with von Willebrand disease, according to the Centers for Disease Control and Prevention.
As for what you can do to reduce your sensitivity, there isn’t much in the way of good news: DerMend, a product that’s available over the counter, can help with clotting, Friedman says. Unless a test shows you’re deficient, you probably don’t need to reach for vitamin C or zinc supplements—they’ll just go through your body and into your urine, Lipman says. “Maybe just avoid contact sports,” he says. “And be more careful and aware of your body.”
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