Should I worry about bruising?

<span>Photograph: Glasshouse Images/Alamy</span>
Photograph: Glasshouse Images/Alamy

Bruises are most common at either end of life: in childhood because bumping into things is part of the rough-and-tumble of learning about the world; in old age because it becomes less avoidable. But for a few of us, bruises are a regular occurrence, perhaps because of diet, illness or a vigorous five-a-side schedule. But when do they go from inconvenience to alarm bell? And is there anything you can do to make yourself a bit less … peach-like?

To get the basics out of the way, a bruise is what happens when blood vessels get damaged, allowing blood to leak into the tissues under the skin. You can typically get an idea of how old (and close to healing) a bruise is by the colour: bruises are often red when they first appear, but within a day or two, the heme that gives blood its signature colour will break down, and the bruise will look bluish-purple or even black. Later, as that heme is metabolised into different compounds, the bruise will eventually turn green, then yellow or light brown, especially on lighter skin. The body is entirely capable of taking care of these sorts of bruises on its own.

So when should you worry? “When you haven’t bumped into anything or knocked yourself, but you’re still noticing bruises appearing over your body without reason or explanation, that can be a concern,” says Nicole Scully, interim CEO of Leukaemia Care. “It’s also sensible to be alert for other symptoms, including unusual bleeding, repeated infections and excessive tiredness or fatigue, as well as new and unexplained aches and pains.”

If your bruises mostly appear in the places that you’d expect to bump – think shins and elbows – it’s less of a concern than bruises on the torso or other soft tissue areas, which might show underlying problems. Similarly, if a bruise is unusually dark, or seems to be growing rather than fading, it could be the sign of an underlying problem.

“The bruises that appear as a symptom of leukaemia, for instance, can vary in size from small to like a dinner plate and deep purple in colour,” says Scully. “Those that are smaller can often appear in unusual places as well. If you cannot explain the reason behind your bruising and are experiencing anything like this, especially alongside the other most widely reported symptoms, that would be the time to visit your GP and request a blood test.”

But what about bruising more generally? If you tend to bruise easily, it can be because your capillaries are more fragile than is normal – something that arises with age, but can also be caused by other things. Medications including steroids, blood thinners and anti-inflammatories can lead to easier bruising, but so can over-the-counter painkillers such as aspirin or ibuprofen. If you’re not taking any of these, bruising could be symptomatic of an underlying medical condition, ranging from anaemia to malnutrition. The simplest deficiencies to address are vitamins C and K – leafy greens and certain types of cruciferous veg are abundant in both, so consider adding some spinach or asparagus to your breakfast for a simple fix. More seriously, bruising can be a symptom of excess alcohol intake: alcohol acts as a vasodilator, making blood vessels larger and meaning you’re more prone to bruising while drinking – but more serious bruising can also be a symptom of degeneration in liver function. Excess sun can also cause damage to blood vessels, making bruising easier, while smoking can cause vasoconstriction, or narrowing of the blood vessels, meaning that bruises take longer to heal.

In general, then, just getting a bruise is nothing to worry about; the time for concern is if it comes accompanied by other warning signs, or happens more frequently than your lifestyle choices should suggest. Bruises may be a part of everyday life, but – as with many things – just being aware of your own body’s tendencies can give you a warning when something goes awry.