What Causes Bruising under Skin? Anemia, Vitamin Deficiency, Medications

What causes bruising is a common concern among members of online health forums. This articles will explore the various factors that trigger excessive, easy and random bruising ranging from medications and vitamin deficiencies to bleeding disorders like anemia?

What Causes Excessive, Random and Easy Bruising?

Bruises are unsightly, no doubt, but they can be even more bothersome when they hurt or are extremely swollen. The question then is, what causes bruising easily, randomly, and sometimes excessively. Below are a few common causes of bruising:

Direct trauma and injury: Trauma from blunt objects is the most common and obvious cause of bruises. This can for example happen from a car accident, sport injury, bumping into something e.g. furniture, or assault.

Bruises occur when the small blood vessels (capillaries) close to the surface of the skin get broken from the impact of such traumatic blow or injury.

This causes blood to leak into the surrounding soft tissues leading to the formation of the characteristic blue-black or purplish discolorations that later on changes to various shades of color as one undergoes the various stages of bruise healing.

Aging: The natural aging process also plays a role in bruising and could easily be your best answer if you wondering what causes bruising while at the age of 60 years going forward.

As we grow old, two things essentially happens to the skin: First, the skin thins out and loses its underlying fatty tissue, thus losing the cushioning effect provided by these fats to the skin and blood capillaries. Secondly, the body’s ability to produce collagen – an important component of the skin which strengthens the skin and blood vessels declines.

As a result of these two factors, the skin becomes more susceptible to bruising even where small insignificant impacts that would have had no impact earlier on are involved.

Exercise and strenuous activities that place excessive pressure on blood vessels could as well be the causative factor for some cases of random bruises that occur for no apparent reason. Such activities often cause microscopic tears in the blood vessels beneath the surface of the skin, ultimately leading to bruising on legs, thighs, abdomen etc. Athletes and weight lifters are at higher risk of such kind of bruises.

Does Anemia Cause Bruising?

We often see the question, “Does anemia cause bruising?” Well, anemia can cause bruising. Anemia is characterized by lack of enough healthy red blood cells i.e. their count is too low or only a small and insufficient number of them have enough hemoglobin – the iron rich protein that helps to transport oxygen in the body.

Random, excessive and/or easy, bruising is common with a type of anemia called aplastic anemia which is characterized by low count of not only red blood cells but also white blood cells and platelets (the blood clotting agents in the skin). This is usually as a result of bone marrow stem cells’ damage or failure which could be triggered by a disease or the genetic makeup of an individual.

Without enough platelets, blood clotting ability gets impaired and any breaks (even small ones) in blood capillaries don’t get sealed as easy, often leading to excessive bleeding and bruising (collection of blood below the surface of the skin).

What Vitamin Deficiency Causes Bruising?

Excessive and easy bruising is often linked to nutritional deficiencies. So, what vitamin deficiency causes bruising? Unexplained bruises are common with deficiency of vitamins C, B12 and K.  Bruising can also occur as a result of deficiency of folic acid.

Vitamin C is required for synthesis of collagen – an important supportive tissue that enhances the skin and blood vessels’ ability to withstand impacts and trauma that could potentially cause bruising. Good sources of vitamin C include citrus fruits (e.g. oranges), and green leafy vegetables.

As for vitamin K, it is essential for proper clotting of the blood and its presence in adequate amounts could thus be a precursor to easy bleeding and unexplained bruising. You can for example run low on vitamin K after being placed on antibiotics that destroy useful vitamin K micro-organisms in the digestive tract. Green leafy vegetables are an excellent source of vitamin K and so are broccoli and Brussels sprouts.

NB: You can as well get some vitamin supplements over-the-counter at your local drugstore.

Can a Bruise Cause a Blood Clot?

In one health forum, a person by the name of Annette was concerned about a bruise on her leg and asked, “I have this large bruise on my leg that I sustained last week after my team mate accidentally hit me from behind. Can a bruise cause a blood clot in my veins?”

Well, to answer this, it is perhaps important that we clarify the difference between a blood clot and a bruise. A bruise is a black-blue, reddish, or purplish marks that appear beneath the surface of the skin after a bump or injury that does not involve a cut or abrasion. A blood clot on the other hand is a semi-solid or gelatinous mass of coagulated blood.

We can thus say that a blood clot help a bruise to heal but a bruise cannot cause a clot. In the event of a bruise, clotting happens outside the blood vessels that had been damaged and was bleeding.

What Annette people that ask this question are usually afraid of is to develop a serious blood clot inside a vein deep occurring deep in the leg; a condition known as Venous thromboembolism or VTE if you like. Such a clot can break off and find its way to the lungs where it could then be fatal.

Coming back to the question, “can a bruise cause a blood clot in my vein?”, the answer is no, but the trauma or injury that caused the bruise in the first place could even though that is a rather rare occurrence. This can happen when the injury damages the wall of the deep seated vein making ideal conditions for the formation of a deep vein clot.

If you are concerned about your bruise; may be it feels particularly painful, is very swollen, or doesn’t seem to be improving even with a regimen of bruise healing measures; then you should seek the attention of your doctor.

Medications That Cause Bruising

Using various medications has also been shown to cause excessive and easy bruising as a side effect. Notable among these medications that cause bruising are

  • Aspirin: This is a common pain relieving medication
  • Anticoagulant medications such as warfarin (commonly sold as Coumadin)
  • Non-Steroidal Anti-Inflammatory Drugs (or NSAIDs) such as ibuprofen (commonly sold as Advil, Motrin)
  • Quinine: Typically used to treat restless legs
  • Quinidine (commonly used for treatment of cardiac arrhythmias
  • Topical and systemic corticosteroids such as prednisone: Commonly used to treat asthma, eczema and allergies but their long term use causes a thinning effect on the skin which then leads to easy bruising.

Most of these medications reduce the ability of your blood to clot. This means that any small injury to capillaries will lead to unnecessarily longer bleeding time which then gives more time for leakage of blood below the skin, leading to the formation of bruises.

NB: some dietary supplements can also increase the risk of easy and unexplained bruising.

Blood Diseases That Cause Bruising

Most cases of bruising are not a cause for concern and will go away without necessitating treatment, easy bruising may be an indication of a more serious blood clotting related problem. This is especially true of bruises that recur so frequently or take particularly long to heal.

Blood tests are usually done to determine blood count and clotting time and hence rule out such diseases.Among the blood diseases that cause bruising are:

Hemophilia:This is a rare genetic blood clotting disorder whereby the affected person inherits some problems with certain blood-clotting factors. Because blood clotting factors play a key role in formation of clots and stopping the bleeding after an injury, people with hemophilia tend to bleed excessively and form bruises (where no cuts in the skin are involves).

Hemophilia commonly affects men even though women can be carriers for the defective genes.

Thrombocytopenia: This is another blood clotting disorder that is characterized by presence of too few platelets in the blood which then makes it not able to clot properly. It is linked to certain diseases and conditions that destroys the platelets in a person’s blood. Some medications could also cause this.

Symptoms of thrombocytopenia are easy to frequent nosebleeds, heavy menstrual periods, and excessive bleeding, small (pinpoint-sized) red spots – called petechial) around the ankles and feet.

Von Willebrand’s disease: This is a genetic blood disorder that is characterized by poor clotting of blood due to lack (or presence in inadequate amounts) of Von Willebrand factor (an essential blood clotting protein found in blood) in the blood. Whenvon Willebrand factor is not present, platelets are not able to stick together normally to form a clot at a bleeding site.

Symptoms of von Willebrand’s disease range from easy bruising to excessive bleeding (when injured), heavy menstrual cycles, frequent nosebleeds, bleeding from the gums, and blood in urine and stool.

Leukemia (cancer of blood): This blood condition is characterized by impaired production of red and white blood cells and is a common trigger of easy bruising of the limbs.

What Causes Bruising Under the Skin?

We recently got this question from one of our esteemed readers and thought it might be worth the time to include it in this guide:

“I am 29 years old mother of two and have lately been spotting small, random sized bruises on my thighs. They seem to stay on for just a few days and then go away. Could this be some disease I am picking up at the gym?”

Well, as we have already mentioned elsewhere in this article, exercising rigorously often causes microscopic tears in blood vessels (especially capillaries) beneath the skin. Such vessels then leak blood into the soft tissue underlying the skin resulting in the discoloration that we then perceive as a bruise(s).

As the blood components get absorbed back into the body, the bruise changes to different color shades and fades away gradually until it is no more.

If you have been taking any blood thinning medications such as aspirin and warfarin, then they could as well be to blame. If the bruises keeps recurring, it may be a good idea to get checked by your doctor to rule out blood related disorders such as anemia and hemophilia among others. The same case applies if your frequent bruising is accompanied by heavy menstrual flow or frequent nosebleeds.

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One comment

  1. I have a red bruises that appears on my legs, may be due to my menstrual period. but my problem is, it never fades.

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