Bruises happen – a bump here, a fall there – and most of the time, they’re no big deal. But if you notice frequent, unexplained bruising, it might be time to check in with your physician.

“If you feel like you bruise more easily, if you bleed when you brush your teeth or you cut yourself and it doesn’t stop quickly, that’s when I’d recommend talking to your doctor,” says Dr. Michael Remines, a family and internal medicine provider at Tidelands Health Family Medicine at The Market Common.

What is a bruise?

A bruise is the visible result of damaged blood vessels beneath the skin, often caused by impact. The discoloration is blood leaking into surrounding tissues. 

Here are three common reasons you might bruise more easily:

As we age, our skin naturally becomes thinner and loses some of its protective fatty layer. That means less cushioning for blood vessels, making them more vulnerable to damage.

Sun-exposed areas, such as arms or legs, are particularly vulnerable as we age, says Dr. Remines.

Certain medications can increase the risk of bruising:

• Antiplatelet medications such as aspirin and clopidogrel
• Non-steroidal anti-inflammatory medications, including aspirin, ibuprofen and naproxen sodium
• Anticoagulants such as warfarin, Eliquis, Lovenox and Xarelto
• Steroids, including prednisone and hydrocortisone
• Some supplements, such as vitamin E, fish oil and ginkgo
• Penicillin- and cephalosporin-type antibiotics
• SSRI antidepressants such as Prozac, Zoloft and Paxil

“A lot of times, patients are taking something over the counter like an aspirin three times a day,” he says. “Sometimes patients don’t even think to tell you because it’s over the counter.”

When you speak with your care provider, make sure you have a list of every medication you’ve been taking — even those you can buy off the shelf at the grocery store.

Certain medical conditions can also cause unexplained bruising, including:

• Clotting disorders like hemophilia and von Willebrand disease
• Autoimmune diseases, such as lupus, which can affect blood vessels and are often treated with steroids
• Leukemia, a type of blood cancer, which may cause small, pinpoint bruises in unusual places that take longer to heal
• Thrombocytopenia, or low platelet count, can make bruising more likely
• Cushing’s syndrome involves high levels of cortisol
• Liver disease can impact the production of clotting proteins

If you have unexplained bruising and symptoms like bleeding from the gums or blood in the urine, make an appointment with your primary care provider.