“Ask Dr. HKSH” - Easy Bruising

Dr. MA Shiu Kwan, Edmond

Specialist in Haematology

HKSH Department of Pathology

Q1. Why do bruises appear?

Bruises often occur after you have knocked over or bumped into something. A bruise appears as the blood vessels are damaged and the blood comes out. The blood sits under the skin and initially as brown patches, which may turn green, yellow and finally disappear.  

Q2. Why do bruises occur frequently in some people? Is it related to thin skin?

Bruises that appear even with a slight bump can still be normal. It is especially so, and therefore normal in young girls, whose skin is more prone to bruising. This phenomenon is termed simple easy bruising.  However, it can signal abnormality if you bruise after a light touch or even without bumping into something, or show petechiae (many red spots commonly over both shins). In this case, you should see a doctor and check for any health-related issue.

Q3. What to alert for unexplained bruises?

Unexplained bruises can be a warning sign of the following four conditions:

1. Decrease in platelet count, which is most common;

2. Currently on antiplatelet medication;

3. Platelet function disorders involving different forms;

4. Inherited blood coagulation disorder, such as Von Willebrand disease (VWD).

Your doctor will check for these conditions during consultation.

Q4. When should I see a doctor or undergo examination?

It may indicate bleeding tendency if you bruise even with no bumps, have tiny petechiae on your body, especially the legs, or bleeding continues for a long time after a minor cut. Seek medical attention as soon as possible. 

Q5. What is immune thrombocytopenia?   

Immune thrombocytopenia is a common condition in which one’s platelet count falls. It occurs when the platelet-binding autoantibodies attack the platelets and cause platelet destruction in the spleen, resulting in shorter lifespan and decrease in total number of platelets. The platelet count may drop to a very low level, or even single digits as the bone marrow, though actively trying to compensate, simply fail to produce enough platelets to correct the low platelet count. 

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