Why Do I Bruise so Easily & When to Worry about Bruises in Adults?

• Coagulation disorders

Coagulation is a complex process that involves the interaction of many mediators and proteins, and when any step of this process is disrupted, consequences will affect the whole pathway. The leading causes of easy bruising that is related to coagulation are:

    1. Hemophilia A: Hemophilia A is one of the most common diseases related to coagulation. It results from the absence of factor VIII, which is integral in the coagulation cascade and which appears soon after birth in most cases, patients are mostly males as it is a sex-related genetic disease.
    2. Hemophilia B: Also known as Christmas disease, it results from the absence of factor IX. Males are also the vast majority of patients.
    3. Vitamin K deficiency: Vitamin K is one of the fat-soluble vitamins that is produced from the bacteria of our gut and our diet, especially leafy vegetables. Its deficiency has recently been attributed to the rise in the abuse of antibiotics that led to the unwanted elimination of gut bacteria that produce the vitamin.
    4. Liver disease: The liver is both the filter and the manufacturing plant of our bodies; it produces many proteins that are essential for the functioning of our coagulation as well as most coagulation factors. Any disease that causes liver dysfunction will certainly affect coagulation. These diseases may include alcoholic liver disease, viral hepatitis and fatty liver disease.
    5. Von Willebrand disease: Like hemophilia, Von Willebrand disease is the congenital absence of a coagulation factor that also functions in the normal adhesion of platelets.
    6. Drugs: Drugs such as Warfarin and Heparin act through the inhibition of coagulation and are used in many conditions when blood thinning is needed. Patients receiving those drugs include cardiac patients who underwent mechanical valves implantation in their hearts, those with conditions liable to have blood clots like deep vein thrombosis and lupus with pregnancy. The main disadvantage of those drugs is that they must be finely calibrated; otherwise, toxicity will happen, and one of the main signs of toxicity besides bleeding is the development of bruises.