Easy Bruising

Ecchymosis / Contusion

Mild severity32% reported by patientsICD-10: R23.3

Summary

Bruises that occur with minimal or no trauma, possibly indicating a bleeding disorder, medication effect, or nutritional deficiency.

What is it?

Easy or unexplained bruising (ecchymosis) is a common complaint, particularly in women and older adults. Most easy bruising is benign — aging skin has less supportive collagen and subcutaneous fat, making blood vessels more susceptible to minor trauma. Corticosteroid-thinned skin, anticoagulant medications (warfarin, aspirin, NOACs), and platelet disorders are common medical causes. Severe bruising with gum bleeding, heavy menstrual periods, and prolonged bleeding after cuts raises concern for an underlying bleeding disorder.

Common causes

Benign / Physiologic

  • Aging skin (senile purpura)
  • Fair, thin skin
  • Women (more common than men)
  • Minor unremembered trauma

Medications

  • Anticoagulants (warfarin, apixaban, rivaroxaban)
  • Aspirin and NSAIDs
  • Corticosteroids (long-term use)
  • SSRIs
  • Fish oil and herbal supplements (ginkgo, garlic)

Bleeding Disorders

  • Thrombocytopenia (low platelets)
  • Von Willebrand disease
  • Hemophilia
  • ITP (immune thrombocytopenic purpura)

Systemic Disease

  • Liver disease (impaired clotting factor synthesis)
  • Cushing's syndrome
  • Vitamin C deficiency (scurvy)
  • Vitamin K deficiency

When to see a doctor

  • 1Large, spontaneous bruises without any trauma — especially on the trunk
  • 2Easy bruising with prolonged bleeding from cuts, gum bleeding, or heavy periods
  • 3Bruising in a child — must always evaluate for physical abuse
  • 4Bruises that are raised, painful, or recur in the same location without trauma
  • 5Easy bruising with fatigue, pallor, and recurrent infections (bone marrow failure)

What you can do

  • ✓Ensure adequate vitamin C and K intake — both support vascular integrity and clotting
  • ✓Apply a cold compress immediately after injury to reduce bruise size
  • ✓Elevate the bruised area to reduce pooling of blood in tissues
  • ✓Review all medications and supplements with your provider — many common products affect bleeding

Conditions that cause this symptom

AnemiaD64.9Chronic Kidney DiseaseN18.9Alcohol Use DisorderF10.20

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Vitamin K (phytonadione)

Vitamin K deficiency or warfarin-related bruising

Desmopressin (DDAVP)

Mild von Willebrand disease and mild hemophilia A

Frequently asked questions

This page is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or a qualified health provider with questions about your symptoms or medical conditions.

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