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If you have diabetes and you feel like your skin bruises too easily, it may not be your imagination. One of the minor side effects of diabetes — both type 1 and type 2 — is a tendency for bruises to form easily and heal slowly.
Bruising is usually not a serious problem, but it can be a bad sign for your overall health. The culprit, as usual with diabetes, is high blood sugar.
What Is Bruising, Exactly?
Bruising — the technical term for a bruise is a contusion, or ecchymosis — occurs when blood vessels underneath the skin rupture and blood leaks out into surrounding tissues. Bruises can look yellow, blue, red, purple, or black, and will change colors over time as they heal. They may or may not be painful.
Bruises can look pretty ugly, but most of the time they aren’t a big deal and will heal by themselves. There are exceptions, though, when a bruise requires medical attention.
The word hematoma is used to describe a more serious level of bruising, in which there is enough clotted blood to give the skin a raised or lumpy feeling. Hematoma can be the result of a more severe injury and may require a doctor’s help to heal properly.
Diabetes and Easy Bruising
Diabetes doesn’t cause bruises to happen without explanation, but it can cause bruises to develop more easily from common injuries and slow down the bruise healing process.
Like most diabetic complications, enhanced bruising is ultimately caused by chronic elevated high blood sugar levels, which lead to both blood flow issues and delayed wound healing. Impaired blood circulation in people with diabetes inhibits the flow of oxygen, nutrients, and immune cells to wounds. Diabetes is also associated with blood clotting abnormalities, blood vessel dysfunction, and imbalances in collagen formation, which makes the skin stiffer and less flexible. All of these unfortunate effects may contribute to easy bruising.
Bruising is not generally considered serious, though in rare cases bruises may need medical attention. Consider this anecdote from a Massachusetts hospital network, in which a woman with long-standing type 1 diabetes bumped her shin on a bike pedal and the bruise just wouldn’t heal itself. She ended up needing months of care for it. In the worst-case scenarios, wounds that do not heal can eventually lead to amputation.
Diabetes Bruises
In addition, diabetes may make certain types of bruises more likely to occur in the first place. If you have neuropathy and reduced feeling in your extremities, you may be more likely to bang them into heavy objects. A common issue is injuries to the feet — if you don’t realize that you have a pebble in your shoe because your foot has lost so much feeling, it could cause damage without your knowledge.
And the syringes we use for injectable medications, including insulin and GLP-1 receptor agonists like Ozempic, can also cause bruising, as can the lancets needed for fingerstick blood sugar measurements. These bruises are less likely to occur if you use a brand-new sharp needle every time and if you don’t press too hard. Insulin pumps and continuous glucose monitors can also cause bruising.
Frequent bruising from needles may help provoke the formation of lipohypertrophy, fatty lumps underneath the skin that interfere with medicine absorption. More immediately, they may cause embarrassment.
Other Causes of Easy Bruising
Diabetes isn’t the only cause of easy bruising. The Cleveland Clinic indicates some of the other potential culprits:
- Older age (the skin thins and offers blood vessels less protection)
- Many medications, including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and corticosteroids
- Family history of easy bruising
- Some dietary supplements, including ginkgo biloba
- Blood disorders such as hemophilia
- Vitamin C or K deficiency
How to Treat Bruises
Most bruises take care of themselves, but you might be able to accelerate the healing process with a little first aid:
- Rest and elevate the bruised area to reduce blood flow to the bruise and help limit bleeding.
- Apply ice to slow the blood flow and reduce swelling and pain.
- Wrap a light bandage around the bruise to reduce swelling.
When to Call a Doctor
A bruise doesn’t usually need attention from a doctor, but bruises that do not occur or heal normally may call for an examination. You might want to see a healthcare provider if you experience:
- Unexplained bruising
- Recurring bruising
- Bruises that do not seem to heal
- Bruises that are unusually painful or lumpy (hematomas)
Diabetes and Other Skin Problems
A variety of unrelated skin problems is common in both type 1 and type 2 diabetes. People with diabetes are more likely to experience both general skin issues, such as dry skin and fungal infections, and more specific conditions, such as “shin spots” or diabetic dermopathy.
The skin is the largest organ in the body, and its many blood vessels and nerves experience dysfunction when subjected to high blood sugars — just like the rest of the body. Even harmless skin issues are often considered warning signs that hyperglycemia needs to be addressed before it leads to more serious problems, such as heart or kidney health complications.
Takeaways
Diabetes, which impairs blood circulation and wound healing, can cause easy bruising and slow bruise healing. Optimal blood sugar management may help, as can protecting the body from injury in the first place.
Bruises are usually not considered serious, but in rare cases they may require medical attention. Easy bruising may also be a warning sign that you have already experienced a measure of hyperglycemia that could cause other more dangerous complications. Pay attention to your bruises, and let your healthcare provider know if you have bruises that develop mysteriously or that seem unable to heal.
