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Easily Bruised
July 2002

Q. I am a 54-year-old woman, an ex-smoker, am on hormone replacement therapy, and I find numerous bruises on my body. I bruise very easily. I had a CBC and it came back normal. Can you explain the different reasons why a person can easily bruise?

A. Easy bruising is a common complaint in a medical office, and while often harmless, it needs investigation. It can occur as a consequence of aging for two reasons; there is a loss of the fat layer under the skin that protects the capillaries (small blood vessels) from injury, and the blood vessel walls themselves become more fragile. Evaluation would include a CBC (complete blood count) as you have done, which clarifies whether you have the normal numbers of red blood cells, white blood cells, and platelets (the cells that form a clot to stop bleeding). In addition a protime or INR blood test will tell whether those cells work properly to stop bleeding. Numerous medications including aspirin and ibuprofen can cause easy bleeding so this must be investigated. The most common reason for bruising is trauma to the skin with bleeding as a result. This will usually show up as bruises on the arms or legs due to their "exposure" to trauma, so large bruises in other areas, or bleeding from the gums or the nose are unusual and need further medical evaluation.



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