Easy bruising: Aging-related causes

Yet another bruise. Where did that dark, unsightly mark on your leg come from? You don't recall bumping into anything. But lately you've been bruising more often than you used to. Should you be concerned?

It's common to experience increased bruising as you age, and most bruises go away without treatment. Still, bruising can sometimes be a sign of a more serious problem. Find out what causes easy bruising as you age and when you should discuss your bruises with your doctor.

Age-related causes of easy bruising in older adults

Most bruises form when small blood vessels (capillaries) near your skin's surface are broken by the impact of a blow or injury. When this happens, blood leaks out of the vessels and initially appears as a bluish-black mark. Eventually your body reabsorbs the blood and the mark disappears.

Some people — especially women — are more prone to bruising than are others. As you get older, several factors may contribute to increased bruising, including:

• Aging capillaries. Over time, the tissues supporting these vessels weaken, and capillary walls become more fragile and prone to rupture.
• Thinning skin. With age, your skin becomes thinner and loses some of the protective fatty layer that helps cushion your blood vessels against injury. Excessive exposure to the sun can affect your skin much like aging does.

Generally, the harder the blow, the larger the bruise. However, if you bruise easily, a minor bump — one you may not even notice — can result in substantial discoloration. Your arms and legs are typical locations for bruises.

Medications and supplements can cause easy bruising

Blood-thinning drugs such as aspirin and warfarin (Coumadin) or medications such as clopidogrel (Plavix) reduce your blood's ability to clot. Because of this, bleeding from capillary damage that would normally stop quickly may take longer to stop, allowing enough blood to leak out to cause a bruise.

Corticosteroids also can cause your skin to thin, making it easier for you to bruise. Don't stop taking your medications if you experience increased bruising. Talk to your doctor about your concerns and what you can do.

Certain dietary supplements such as fish oil, ginkgo, ginger and garlic also may increase your bruising risk, since these supplements have a blood-thinning effect. Make sure your doctor is aware of any supplements you're taking — especially if you're taking them along with a blood-thinning drug. Your doctor may recommend avoiding certain over-the-counter medications or supplements.

When bruises indicate more serious problems

In some cases bruising may indicate something more serious, such as a blood-clotting problem or a blood disease. See your doctor if:

• You have unusually large or painful bruises, particularly if your bruises seem to develop for no known reason
• You're bruising easily and you're experiencing abnormal bleeding elsewhere, such as from your nose, gums or intestinal tract
• You have no history of bruising but suddenly experience bruises, particularly if you recently started a new medication

These signs and symptoms can indicate that you have low levels — or abnormal function — of platelets, a component of blood that helps blood clot after an injury. To diagnose the cause of your bruising, your doctor may check your blood platelet levels or the ability of your blood to coagulate.

Other serious causes of bruising include domestic violence or abuse. If a loved one has an unexplainable bruise, particularly in an unusual location such as around the eye or face, discuss the possibility of abuse.

Avoiding bruises

Once a bruise has formed, not much can be done to treat it. It will eventually disappear as your body reabsorbs the blood.

If swelling is associated with the bruising, applying a cold compress for 20 minutes at a time and elevating the affected area may help. After the swelling has gone down, a warm compress may speed reabsorption.

To prevent minor bruising, eliminate household clutter that could cause bumps or falls. Long-sleeved shirts and pants may provide an extra layer of protection for your skin. Avoid prolonged exposure to the sun to help you avoid its aging effects and the increased bruising risk that may result.

If the sight of your bruises bothers you, try covering them with makeup until they've healed.