Bruising and bleeding both occur because of damage to blood vessels. When a vein, artery, or capillary is torn or cut, blood flows out into the vessel’s surroundings; if the escaped blood is contained within the tissues directly under the skin, we see a bruise. While all of us bruise from time to time, some people bruise particularly easily. A number of factors, besides being accident-prone, can make this occur.
One factor contributing to easy bruising is thinning skin, caused by aging or by medications such as corticosteroids. Easy bruising can also be due to fragile blood vessel walls. Finally, difficulties with blood clotting, including problems with platelets or clotting factors, can also increase bruising. For this reason, strong blood-thinning drugs such as heparin and warfarin (Coumadin) can lead to excessive bruising. Warning: if you’re taking these or other anticoagulant drugs and notice increased bruising, contact your doctor, as this situation could be dangerous.
Aspirin or even natural remedies such as high-dose vitamin E, ginkgo, and garlic may also thin the blood, possibly raising the risk of bruising and other bleeding problems; and if you combine two blood-thinning substances, these effects might multiply. Rarely, severe bruising from minor or unnoticed injuries can be a sign of leukemia or another serious health problem. Especially if this is a new development, discuss your symptoms with a doctor.
However, in most cases, there is no identifiable medical cause for easy bruising, and no conventional treatment. Furthermore, once you have a bruise, there is no conventional therapy to help speed its resolution. Three small double-blind studies, involving a total of about 80 athletes, found that treatment with proteolytic enzymes significantly speeded healing of bruises and other mild athletic injuries as compared to placebo.
A number of natural substances might be helpful for easy bruising, including citrus bioflavonoids, the related substances OPCs and bilberry, and vitamin C. In addition, if you already are bruised, you may found some help with a combination of two proteolytic enzymes, trypsin and chymotrypsin or a topical preparation of escin (an extract of horse chestnut).
Risk factors for Bruising Susceptibility
Bioflavonoid Need
A double-blind study of 96 people with fragile capillaries found that bioflavonoids decreased the tendency to bruise [Int Angiol. 1993;12: pp.69-72]. In a single-blind study of 27 wrestlers, 71% of those taking a placebo were injured, with bruises making up more than half their injuries; in contrast, only 38% of those taking the supplement were injured, none of whom sustained bruises. In a follow-up double-blind study of 40 football players, the treated group received fewer severe bruises than the group taking placebo [Med Times. 1960;88: pp.313-316].
Cirrhosis of the Liver
When the liver slows or stops production of the proteins needed for blood clotting, a person will bruise or bleed easily.
Bruising Susceptibility suggests the following may be present
Cirrhosis of the Liver
When the liver slows or stops production of the proteins needed for blood clotting, a person will bruise or bleed easily.
Recommendations for Bruising Susceptibility
Increased Fruit/Vegetable Consumption
Many people eat insufficient amounts of foods containing vitamin C; the disease caused by vitamin C deficiency, scurvy, causes easy bruising. While very few people actually have scurvy, even minor deficiencies of vitamin C can increase bruising. Fruits are common dietary sources of vitamin C.
Bioflavonoids
A double-blind study of 96 people with fragile capillaries found that a combination of the bioflavonoids diosmin and hesperidin decreased the tendency to bruise. Participants took 2 tablets daily of these bioflavonoids or placebo for 6 weeks, while researchers used a suction cup to measure their capillaries’ tendency to rupture and also looked for spontaneous bruising and other symptoms of fragile capillaries. Those individuals who received bioflavonoids had significantly greater improvements in both capillary strength and symptoms compared to those taking placebo. [Int Angiol. 1993;12: pp.69-72]
Two other studies from the 1960s found benefits with a combination of vitamin C and citrus bioflavonoids for decreasing bruising in collegiate athletes. In a single-blind study of 27 wrestlers, 71% of those taking placebo were injured, with bruises making up more than half their injuries; in contrast, only 38% of those taking the supplement were injured, none of whom sustained bruises. In a follow-up double-blind study of 40 football players, the treated group received fewer severe bruises than the group taking placebo.[Med Times. 1960;88: pp.313-316]
Vitamin K1/K2
Low levels of vitamin K are sometimes suspected as a contributing factor to bruising. Vitamin K is found in foods such as green leafy vegetables, soyfoods, egg yolks and cauliflower.
Vitamin C (Ascorbic Acid)
Easy bruising is a symptom of low vitamin C levels, as seen in scurvy. While very few people actually have scurvy, even minor deficiencies of vitamin C can increase bruising.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| May do some good |
| Likely to help |
Glossary
Capillary
Any of the smallest blood vessels connecting arterioles with venules and forming networks throughout the body.
Bruise
Injury producing a hematoma or diffuse extravasation of blood without breaking the skin.
Clotting Factors
Substances in the bloodstream, especially vitamin K, that are important in the process of blood clotting. Prolonged bleeding is produced when these substances are absent.
Anticoagulant
A substance that prevents or delays blood clots (coagulation).
Vitamin E
An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Proteolytic
Commonly: Proteolytic (protein-digesting) Enzymes. Enzymes that are able to break down certain proteins, yet do not attack the beneficial proteins that make up the normal cells of the body. These proteolytic enzymes are said to have great value in fighting cancer as well as many other diseases. If the body were always capable of producing adequate proteolytic enzymes, it is possible that cancer would not develop. In theory, cancer cells have a type of protein coating that is destroyed by these proteolytic enzymes. When this protein is destroyed, the body's white cells are able to attack the cancer cells and destroy them.
Enzymes
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Placebo
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Vitamin C
Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Chymotrypsin
An enzyme secreted by the pancreas into the small intestine to assist in protein breakdown.
Topical
Most commonly 'topical application': Administration to the skin.
Protein
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.