How on earth did I get this bruise?

Dear Lucy: I am a woman in her twenties with fair skin and a tendency to bruise very easily. More often than not, I don’t even remember feeling any of the incidents that causes the bruises, and there are many! Could this be an indication that I am iron- or some other vitamin/mineral-deficient? —Black & Blue

Dear B&B: What a great question! Many of us, including Lucy, share your experience of at least occasionally discovering mysterious new bruises with no memory of injury, so Lucy was especially anxious to get an answer. 

MIT Medical Nurse Practitioner Maureen Dobrowsky to the rescue! 

According to Dobrowsky, easy bruising is a very common concern, especially in women. “However,” she adds, reassuringly “a bruise, also known as ‘ecchymosis,’ is generally not a sign of a more worrisome condition, especially in the absence of any other symptoms and when the bruises are only on the legs.” Dobrowsky does, however, recommend making an appointment with your care provider to discuss your easy bruising, as it can sometimes it can be related to infections, illnesses, trauma, inherited bleeding disorders, or dietary deficiencies in vitamin C, vitamin K, or protein. 

Your provider will ask you some questions, she says, “about your diet, activities that could cause injury, and medications or supplements you take regularly — for example, ibuprofen, aspirin, fish oil, and certain antibiotics can cause easy bruising. Your provider will ask about your alcohol use and whether you’ve noticed any signs of infection or illness, such as unexplained fever, weight loss, or fatigue. It will be important to note if you have easy bleeding, very heavy periods, or bleeding that doesn’t stop as quickly as you would expect after even a small injury. Thinking about family history of bleeding, is important, as well.” Your provider will also ask about safety to make sure the bruising isn’t related to violence or abuse. In addition to those questions, your provider will do an exam and might order some lab work.

“It definitely takes at least one appointment,” Dobrowsky tells Lucy, “but in most cases, we can reassure the patient that the easy bruising isn’t part of anything more serious or worrisome.” 

Lucy urges you to take Dobrowsky’s advice, and make an appointment with your primary care provider (PCP) at MIT Medical. Your bruising is probably indicative of nothing more worrisome than occasional clumsiness or inattention — an affliction of Lucy’s as well — but it’s a good idea to rule out anything more pernicious. —Lucy  

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