Bruises probably aren't something you typically give much thought. You might bump into a low table while you're walking through your house, and think, "Ouch, that's going to be a nasty bruise tomorrow." Or maybe you wake up in the morning, notice a purplish-blue mark on your elbow, and think, "Wow, how did this happen?" and then immediately proceed to forget about it. That's because bruises happen to all of us, and they usually aren't a big deal. But the truth is that sometimes bruising can be the sign of a larger health condition that you need to get checked out — and it's important to know how to tell if it is.
In general, a bruise is basically a form of internal bleeding. It's usually caused by some sort of trauma (a bump, a fall, etc.) that makes the blood vessels under your skin tear. When that happens, the blood leaks into the surrounding tissues and clots, which results in that black and blue mark you see on your skin. Some people bruise pretty easily, and that's not necessarily a sign of something larger. I, for example, wake up with bruises quite often, with no recollection of how they got there (I am extremely clumsy). Others don't bruise as easily. It's usually as simple as that!
There are some cases where it isn't that simple, though. It's rare for bruises to be a sign of something more serious, but it can and does definitely happen. Here are a few signs your bruises are part of a larger health condition:
1. Your Bruises Look Like A Rash
If you notice tiny bruises all over that look more like a rash, that could be purpura. Purpura is also known as blood spots or skim hemorrhages, and it's a series of purple-colored spots that can look similar to bruising. It occurs when small blood vessels burst, which cause blood to pool under the skin, creating those purple spots. They can range from tiny dots to large patches, and they can occur on your skin or even on the inside of your mouth. Purpura spots can be nothing, but they could also be indicative of a serious medical condition like blood clotting disorder, which is why they're worth getting checked out.
2. Your Periods Are Very Heavy
Bruising easily is a common affliction. But if you bruise very easily, experience excessive bleeding during an injury, or have super heavy periods, you could have Von Willebrand disease. It sounds scary, but it's actually the most common hereditary coagulation abnormality in humans, so it's quite common. Someone who has it has a deficiency of Willebrand factor protein, which is an important part of the body's blood-clotting process.
3. There's Significant Swelling
If you notice that your bruise is accompanied by a significant amount of swelling and pain, you might want to get it checked out. Sure, it could just be because you fell badly or really bumped into something hard, but Dr. Monique Tello, a primary care physician at Massachusetts General Hospital, says it could also be a sign of a larger bleed under the skin. If the pain and swelling won't go down hours after the injury, you should see a doctor.
4. Your Bruises Get Larger Over Time
Bruises tend to go through stages. You might notice that your bruise gets larger before it gets better, which is fairly normal, especially if you had a very bad injury. But if it just continues to get larger and doesn't seem to be getting any better after two days or so, it could also be a hematoma that could continue to bleed. It could be a sign of a blood disorder.
5. You Notice Bruises In Unusual Places
Since bruises typically happen from some sort of injury or mishap, you're most likely to see the "normal" ones on places like your back, your legs, your arms, and your abdomen. But if you notice bruises in unusual spots, like your joints, that could be the sign of a bleeding disorder. If you notice a lot of these, or a lot of unexplained bruises, see a doctor.
6. You're Always Thirsty
If you bruise easily and often, and also experience symptoms like excessive thirst, blurred vision, and fatigue, you might want to head to a doctor — all of these symptoms combined could be a sign that you have diabetes. Diabetes can disrupt circulation, which can make it easier for skin to bruise. It can also cause people to develop hyperglycemia, which is too much glucose in the blood and can damage blood vessels over time.
7. Your Bruises Look Like Tiny Dots
Do your bruises look more like tiny black and blue dots instead of straight up bruises? If so, it could be something called "petechiae," which happen when tiny capillaries break. They're most common on the neck and chest, and can happen after a lot of straining. But they could also happen on the lower legs, indicating a sign with platelets. If you haven't strained yourself and notice them, go to a doctor.
8. You Have Swollen Gums
Scurvy might sound like something that only happens to pirates, but that's not true. It's actually caused by a vitamin C deficiency, which can cause a lot of bruising. Your bruises, if accompanied by swollen and bleeding gums, fatigue, joint pain, and depression, could be a sign of scurvy.
9. You Notice Small Red Dots
Sometimes, bruising can be a sign of cancer — it's rare, but it happens. Specifically, it could be a sign of leukemia, or another blood, bone marrow, or lymph node cancer. Bruises that are a sign of this usually look like small red dots, but could also be in the form of large black and blue bruises as well. If you also notice fevers, chills, night sweats, and bone pains, you should definitely see a doctor.
10. You Bruise Very, Very Easily
Bruising easily is common. But if you bruise extremely easily and excessively, it could be a sign of a clotting disorder called thrombocytopenia. This causes a low blood platelet count. Platelets are responsible for clumping up and forming a plug when blood vessels are injured, and a lack of them will make you bruise very often. It could also be a sign of something else, anything from pregnancy to an immune disorder to even leukemia.