What does easy bruising mean?
In order for bleeding from a damaged vessel to stop, three parts must work: the vessel itself narrows, platelets adhere to the site of damage and form a plug, and coagulation factors strengthen it with fibrin threads. Failure in any link is manifested by a tendency to bruises. Vascular damage and a lack of platelets lead to small superficial hemorrhages and petechiae, and a deficiency of coagulation factors leads to large deep hematomas and hemorrhages in the joints. It is important for the doctor where the bruises are located, what size they are, how quickly they appeared, and whether there are other types of bleeding.
- Vascular link - petechiae and small bruises
- Platelet link - bleeding gums and nose
- Plasma link - large hematomas
- The size and location of bruises are important
- Combination with other bleeding matters
Possible reasons
Often the reason is harmless: with age, the skin thins and the blood vessels become fragile, so older people easily bruise on their forearms from the slightest touch. In young women, increased fragility of blood vessels is often familial. A significant group of causes are medications: blood thinners, non-steroidal anti-inflammatory drugs, hormonal drugs, as well as long-term use of external and systemic glucocorticoids. Less commonly, bruises are caused by a decrease in platelet count, liver disease, vitamin deficiency, hereditary coagulation disorders and diseases of the blood system.
- Age-related vascular fragility
- Family tendency to bruise
- Antiplatelet agents and anticoagulants
- Nonsteroidal anti-inflammatory drugs
- Long-term use of glucocorticoids
- Decreased platelets and blood diseases
- Liver disease and vitamin K and C deficiency
Associated symptoms
Bruises are rarely the only manifestation when it comes to illness. You should be wary of nosebleeds, bleeding gums when brushing your teeth, long and heavy menstruation, bleeding after tooth extraction or small cuts that do not stop for a long time. General weakness, shortness of breath with normal exertion, pallor, night sweats, prolonged fever, swollen lymph nodes, bone pain require immediate examination. It is also important to remember if you have recently started a new drug and if your relatives have had similar problems.
- Nosebleeds and bleeding gums
- Heavy and prolonged menstruation
- Long bleeding after cuts and dentist
- Weakness, shortness of breath, pallor
- Temperature and enlarged lymph nodes
- Relatives have similar problems
What examinations are needed
The examination begins with a general blood test: it shows the number of platelets, hemoglobin level and leukocyte formula, which allows one to suspect blood diseases. Next, coagulation is assessed: coagulogram or hemostasiogram with prothrombin time, APTT and fibrinogen. Ferritin is checked, since iron deficiency often accompanies chronic blood loss, as well as liver function indicators. If baseline tests are normal and complaints persist, the hematologist may order platelet function tests and special tests for inherited clotting disorders.
- Complete blood count with platelet count
- Coagulogram and hemostasiogram
- Ferritin and iron metabolism indicators
- Liver parameters
- Platelet aggregation study
- Consultation with a hematologist
- Special tests for suspected hereditary disorders
What to do
A fresh bruise will decrease faster if you apply cold in the first hours, and from the second day use heat and soft external agents. You cannot stop prescribed blood thinning medications on your own: this is dangerous due to thrombosis, but you need to discuss the dose and need with your doctor. Eating a sufficient amount of vegetables, fruits and protein maintains the condition of blood vessels, but uncontrolled intake of vitamins does not replace examination. If a cause is found, they treat it: they compensate for deficiencies, adjust therapy, and in case of blood diseases, they involve a hematologist.
- Cold in the first hours, warm from the second day
- Do not stop prescribed medications on your own
- Discuss all medications and supplements you are taking with your doctor.
- Nutritious food
- Caution during hazardous activities
- Treatment of the identified cause
- Observation by a hematologist for blood diseases