So you’ve hardly ever been bruised before, but lately you’ve been covered with them. Even worse, you can’t recall how you got most of them. It’s probably a good idea to see your doctor to find out what’s going on.
You may bruise more easily because of a new drug you’ve started to take. Or, if you really stop to think about it, maybe you’ve been bumping into things a lot more lately for one reason or another. Maybe you just need a new pair of glasses.
Some health conditions can cause you to bruise more often. Your doctor can diagnose a problem and offer you treatment, if it’s needed.
What Will My Doctor Look For?
When you visit your doctor, there are a number of tests and exams you may get:
Health history. If you’ve had any history of bruising before, your doctor will want to know. They’ll also ask about:
- Diseases you’ve had
- Medicines you take
- Symptoms besides bruising
- Medical history of your closest relatives
- If you have felt ill or have other associated symptoms
- If you've recently had a viral illness
Physical exam. They’ll likely examine you from head to toe, taking note of any bruises on your body. They may be looking at the quality of your skin: Is it paler than it should be? Is it thinner or more fragile than it should be? They may also look for lumps beneath your bruises or enlarged lymph nodes.
- Low levels of red blood cells, which could mean you have anemia
- Your white blood cell count or blood platelet levels if they suspect an infection or bone marrow problem such as leukemia or a myelodysplastic syndrome
- Tumor markers if they suspect another type of cancer
- Low levels of certain clotting factors that may point to disorders like hemophilia or von Willebrand disease (VWD)
- Liver tests because liver disease can cause bruising and clotting factors
Blood-clotting test. Some people with blood-clotting disorders have known about their condition since they were babies. Others may not find out about it until they’re adults. A test called a PT/INR test will be done to see how well your blood clots. The test is a prothrombin time (PT) blood test, and the results are known as an international normalized ratio (INR).
Bone marrow biopsy. You might get this if your blood test leads your doctor to suspect you have a bone marrow issue. After your skin is numbed, a small, hollow needle will be used to remove a bit of marrow from your pelvic bone, along with some blood and bone. The tissue will be studied under a microscope to see if there’s cancer.
How your doctor decides to treat you depends upon your diagnosis. Because the causes of bruising are so variable, treatment can range from simply waiting to see to a bone marrow transplant.
If your bruises are caused by medicine you’re taking, your doctor may prescribe something different. But if the drug’s effects are more helpful than harmful, your doctor may suggest lifestyle changes or other ways for you to try to avoid getting bruised.
If you’re diagnosed with cancer cells crowding out your normal bone marrow, you may need:
- Targeted therapy
- Combination therapy
- Stem cell transplant
- Other special treatments
If you’re diagnosed with a blood-clotting disorder, your doctor may prescribe a drug that can increase the proper clotting factor in your blood. Or you may receive replacement therapy, which is an IV treatment to add the proper clotting factor into your blood.