Why am I bruising so easily?

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Why am I bruising so easily?

Easy bruising is defined as bruising without a history of injury or trauma, and it brings folks to the doctor because they are worried about an underlying medical issue. Bruises on the trunk, back, or face are not typical, and your doctor needs to see that, especially in the absence of any trauma. If your bruises are on the legs and arms, it’s unlikely you have anything to worry about, even if you don’t remember an injury.

Rare causes include low platelets, bleeding disorders, and Vitamin C, K, and protein deficiencies. But know that a bleeding disorder is unlikely if you’ve had invasive procedures, dental work, or past deliveries without a problem. 

The most common culprit of easy bruising we see in primary care is a medication or supplement you’re taking. Here are some well-known offenders: 

  • Antiplatelet medications. Aspirin and Plavix (clopidogrel) are most often to blame for easy bruising. If you take a daily aspirin, don’t be surprised to see bruises on your arms or legs. 

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  • NSAIDS. Ibuprofen, Naproxen, Motrin and Advil inhibit platelet function and will lead to easy bruising.
  • Anticoagulants. This may seem obvious but blood thinners like coumadin (warfarin), lovenox (Enoxaparin), Xarelto (Rivaroxaban) and Eliquis (Apixaban) will cause easy bruising.
  • Steroids. Prednisone and Hydrocortisone cause thin skin and lead to easy bruising in patients taking them. 
  • Antibiotics. Penicillin and Cephalosporins like Cephalexin, Cefaclor and Cefuroxime-Axetil are commonly prescribed antibiotics and a rare cause of easy bruising as a result of low platelets. This is rare. 
  • Antidepressants. Rare again but reports exist of antidepressants causing easy bruising, including Fluoxetine, Sertraline and Paroxetine. 
  • Herbs and Supplements. Don’t forget about these. Fish oil, garlic, Ginkgo and Vitamin E inhibit platelet function and may cause this problem so it’s a good reminder to run it by your doc before you start on any supplements. 

The upshot:  If you notice five or more bruises greater than 1 cm (the width of an average fingernail) in diameter–it’s worth a visit to your doc for a check-up and review of your medication list 

Dr O.