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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
I am a Clinical Associate Professor of Medicine at the Keck School of Medicine of USC and a board-certified Internal Medicine physician. For 20 years I’ve had an active private practice in general internal medicine currently at The Doctors of USC Beverly Hills. I am lucky to spend part of my time as the attending physician for medical students and residents during their rotations at LAC+USC Medical Center. I’ve been a medical advisor on leading health social networking sites including Dailystrength.org and Sharecare and currently serve as the medical advisor and blogger for GoodRx.com, a prescription drug price comparison website, and GoodRx care powered by Hey Doctor.
My philosophy of care centers around seeing things we can see coming, and nailing them head-on. I appreciate the idea of sharing power and responsibility for the choices one makes for prevention, treatment, and investigation into medical problems. My hope is to write blog posts to empower patients to navigate their own health by laying out the ways that medicine can guide you with strategies to investigate, prevent, and treat some common medical issues, big and small.
I have appeared on The Doctors, Fox Sports West, The Ricki Lake Show, as well as many local news outlets and have been featured in numerous online and print publications. I am a fellow of the American College of Physicians and honored to be named “Top Doctor” in Los Angeles and Pasadena Magazine for years.