Hemophilia and Inherited Bleeding Disorders

Bruises

What causes abnormal or easy bruising?

A bruise appears when there is bleeding under the top layer of the skin. Bleeding under the skin usually occurs when small blood vessels tear at the site of an injury. Causes for easy bruising include the following:

Taking blood thinners such as heparin or warfarin.
Drinking large amounts of alcohol.
Too little vitamin C in the diet.
Certain liver and kidney diseases.
Not enough platelet cells in the blood, or platelet cells that don't work normally.
Some prescription medications, over the counter medications (including aspirin and ibuprofen), and herbal remedies can make you bruise more easily because they interfere with normal platelet function.
Blood vessels become fragile and break more easily as people age.
Persons with inherited bleeding disorders such as hemophilia or von Willebrand's disease often bruise easily because they don't have normal amounts of one or more of the proteins necessary for normal blood clotting.

When should I worry about having a lot of bruises?

You should talk to your health care provider about bruising if you have the following conditions:

If you frequently have bruises but you have not had an injury or bump at the site of the bruise.
If you frequently have bruises with lumps under them.
If you have family members who have an inherited bleeding disorder, such as hemophilia or von Willebrand's Disease.
If you have other problems with bleeding such as frequent nosebleeds that are hard to control, more bleeding than expected after surgery, childbirth, or having a tooth pulled, or if you are a woman and have heavy bleeding with your menstrual periods.

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Last Reviewed: Dec 05, 2006

Madeline Heffner, BSN, RN
Nurse Coord., UC Adult Hemophilia Treatment Center
Division of Hematology/Oncology
Department of Internal Medicine
College of Medicine
University of Cincinnati