Bruising

What you need to know

Those tender black and blue marks on your body are often reminders of an accidental bump, although they can be signs of an underlying health condition. According to research or other evidence, the following self-care steps may help reduce bruising:

Sample a combination supplement
Reduce your tendency to bruise by taking a daily combination of at least 400 mg of vitamin C and 400 mg of flavonoids, such as hesperidin or rutin

Fill up on fruits and vegetables
Help prevent bruising by eating more foods rich in vitamin C and flavonoids

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full bruising article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About bruising

Bruising occurs after traumatic injury and consists of swelling and discolouration under the skin but no disruption of the skin.

Bruising is a normal body response to trauma. It is only when bruising occurs often and from very minor (often unnoticed) trauma that a problem may exist. Refer to the capillary fragility article for more information. While easy bruising is usually not a cause for concern, people who experience this problem should consult a physician to rule out more serious conditions that may cause bruising. Medical causes of easy bruising sometimes may be diagnosed from a few blood tests conducted by a doctor. More often, however, no clear cause for easy bruising is found.

Product ratings for bruising

Rating	Nutritional Supplements	Herbs
	Vitamin C (only if deficient)
	Flavonoids
		Arnica (topical) Comfrey (topical) Sweet clover
See also: Homoeopathic Remedies for Bruising
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Bruises look like areas of blue to purple-coloured skin that may turn yellow to dark brown over the course of a few days.

Dietary changes that may be helpful

Even minor dietary deficiencies of vitamin C can lead to increased bruising. People who experience easy bruising may benefit from eating more fruits and vegetables—common dietary sources of vitamin C and flavonoids.

Other therapies

The primary focus in the treatment of bruising is the diagnosis and management of any underlying medical condition. Conditions such as liver or kidney disease; blood disorders, such as haemophilia, platelet dysfunction, thrombocytopenia, leukaemia, and multiple myeloma; connective tissue disorders including scurvy, Marfan’s syndrome, and Ehlers-Danlos syndrome; or the use of blood-thinning medication, such as aspirin (Genuine Bayer, Ecotrin, Bufferin) clopidogrel (Plavix), ticlopidine (Ticlid), and warfarin (Coumadin), should be considered.

Vitamins that may be helpful

Doctors often suggest that people who experience easy bruising supplement with 100 mg to 3 grams of vitamin C per day for a few months. Controlled research is limited, but vitamin C supplements have been shown to reduce bruising in people with low vitamin C intake.¹ Flavonoids are often recommended along with vitamin C. Flavonoids are vitamin-like substances that can help strengthen capillaries and therefore may also help with bruising.² Flavonoids may also increase the effectiveness of vitamin C; citrus flavonoids, in particular, improve the absorption of vitamin C. Older preliminary research suggested that vitamin C, 400–800 mg per day, in combination with 400–800 mg per day of the flavonoid, hesperidin, reduced bruising in menopausal women.³ A small, preliminary trial in Germany gave three people with progressive pigmented purpura (a chronic bruising disorder) 1,000 mg per day of vitamin C and 100 mg per day of the flavonoid rutoside. After four weeks, noticeable bruising was no longer apparent and did not recur in the three month period after treatment was stopped.⁴ Controlled research is needed to better establish whether vitamin C and flavonoids are effective for easy bruising.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

In traditional herbal medicine, a compress or ointment of sweet clover is applied to bruises.⁵ ⁶ Enough should be applied to cover the bruise, and a few applications per day may be necessary to improve healing.

Arnica is considered by some practitioners to be among the best vulnerary (wound-healing) herbs available.⁷ As a homoeopathic remedy, arnica is often recommended as both an internal and topical means to treat minor injuries. Some healthcare practitioners recommend mixing 1 tablespoon of arnica tincture in 500 ml water, then soaking thin cloth or gauze in the liquid and applying it to the injured area for at least 15 minutes four to five times per day.

Comfrey is also widely used in traditional medicine as a topical application to help heal wounds.⁸

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.

References

1. Schorah CJ, Tormey WP, Brooks GH, et al. The effect of vitamin C supplements on body weight, serum proteins, and general health of an elderly population. Am J Clin Nutr 1981;34:871–6.

2. Shamrai EF. Vitamin P. Its chemical nature and mechanism of physiologic action. Uspekhi Sovremennoi Biologii 1968;65:186–201.

3. Horoschak A. Nocturnal leg cramps, easy bruisability and epistaxis in menopausal patients: treated with hesperidin and ascorbic acid. Delaware State Med J 1959;Jan:19–22.

4. Reinhold U, Seiter S, Ugurel S, Tilgen W. Treatment of progressive pigmented purpura with oral bioflavonoids and ascorbic acid: an open pilot study in 3 patients. J Am Acad Dermatol 1999;41:207–8.

5. Moore M. Medicinal Plants of the Mountain West. Santa Fe: Museum of New Mexico Press, 1979, 152.

6. Gruenwald J, Brendler T, Jaenicke C (eds). PDR for Herbal Medicines. Montvale, NJ: Medical Economics Co, 1998, 966–7.

7. Weiss R. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 342.

8. Weiss R. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 342.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008.

2007-09-01