Some people with multiple sclerosis (MS) find that they bruise easily or develop random bruises on their bodies, seemingly out of the blue. “Does anyone else bruise easily?” asked one member of MyMSTeam. “I don’t know if it has anything to do with having MS, but I have noticed I barely hit something, and I bruise like someone has been beating me.”

Another member wrote, “I look like a bruised banana. It’s embarrassing.”

Several possible causes of bruising can be related to MS, including side effects of medications and injuries as a result of bumps or falls. Here’s what you need to know about bruising and how to help prevent it. As with any symptom of MS, talk to a healthcare professional if you’re concerned about excessive or easy bruising.

Can Multiple Sclerosis Cause Bruises?

Multiple sclerosis, on its own, is not known to cause easy bruising. However, the symptoms of multiple sclerosis, as well as certain treatments for MS, can cause a person to develop bruises more frequently than usual.

Minor Injuries, Bumps, and Falls

People with MS may be more prone to everyday injuries than those without the condition, causing them to bruise frequently.

Multiple sclerosis is what’s known as an autoimmune disease. In MS, the immune system attacks the myelin sheath, which is the protective coating shielding your nerves. The nerve damage, known as demyelination, causes lesions within your central nervous system. According to the National Multiple Sclerosis Society, depending on where demyelination occurs, it can affect your motor functions, including balance, movement, and coordination.

Demyelination in parts of the brain responsible for coordination can cause a person to lose their balance, leading to ataxia, a medical term for a lack of muscle control and coordination. MS can also cause vision problems, such as changes in depth perception due to damage to the optic nerve, in addition to unusual sensations.

These unusual sensations might include:

• Dizziness
• Vertigo (a sensation your surroundings are spinning)
• Muscle weakness
• Numbness
• Tremors (shaking)

Many people with multiple sclerosis experience spasticity, which causes muscle stiffness, muscle tightness, or involuntary spasms. Foot drop (being unable to lift the front part of your foot to the proper angle when walking) is one of the most common symptoms of MS that impacts walking.

MS can cause a variety of unusual symptoms. All of these symptoms may make a person with MS more prone to falling or injuring themselves, which can lead to bruises.

MS Medications and Bruising

Bruises often occur when capillaries (small blood vessels near the skin’s surface) break as a result of injury. Blood leaks out of the vessels and breaks down, resulting in the familiar marks. On lighter skin, the initial black-and-blue coloration typically fades to a greenish, yellowish mark before it disappears altogether. On darker skin, bruises typically appear most visibly in the earliest stages and usually look purple, brown, or black.

Many disease-modifying therapies (DMTs) used to treat relapsing MS are injected, either subcutaneously (under the skin) or intravenously (into a vein). If your DMT is injected, you may notice bruising at the injection site.

In rare cases, one DMT in particular can cause bleeding and bruising that may be signs of a serious complication. If you take alemtuzumab (Lemtrada), contact your healthcare provider immediately if you experience any of these symptoms:

• Easy bruising
• Unusual or prolonged nosebleeds
• Excessive or unusual gum bleeding
• Cuts that won’t stop bleeding
• Blood-producing coughs
• Heavier-than-normal menstrual flow
• Petechiae (tiny red, pink, or purple spots on the skin)

Where Did That Bruise Come From?

Multiple sclerosis can cause cognitive symptoms, including short-term memory issues. If you find yourself not noticing or remembering where some of your bruises came from, you may have forgotten a bump or fall. You may not remember how you got small injuries because of numbness or high pain tolerance or because you’ve grown so used to minor bumps that you don’t notice them.

Other Risk Factors for Easy Bruising

According to Hartford HealthCare Medical Group, females and older adults tend to bruise more easily than other people. Apart from MS, there are other conditions and risk factors that can cause you to bruise easily. That includes taking medications and supplements such as:

• Corticosteroids (steroids)
• Anticoagulants (blood thinners)
• Aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)
• Ginkgo (a plant used in some supplements)

Some health conditions can also raise your risk for bruising. These can include:

• Liver disease
• Family history of easy bruising or bleeding
• Bleeding disorders (such as hemophilia or von Willebrand disease)
• Cancer (such as leukemia)
• Deficiency in vitamin C or vitamin K

Another condition that may be associated with MS is immune thrombocytopenia (ITP). Like MS, ITP is an autoimmune disorder. In ITP, the immune system attacks the platelets (blood cells that stop bleeding), which can cause you to bruise more easily.

Seek medical advice if you’re concerned about any of these risk factors for bruising.

Preventing Bruises With MS

If you experience frequent bruises while living with MS, there are steps you can take to reduce or prevent bruising.

Get Help With Medications

If you have trouble sticking to an injected medication due to injection-site bruising or other injection-related concerns, talk to your neurology team. They may have tips for how to avoid bruising or rotate injection sites to make things easier.

If that doesn’t help, ask your doctor about whether switching to an oral (taken by mouth) disease-modifying therapy might be safe and effective for treating your MS. Several oral treatment options are available, and this would eliminate the risk of injection-related bruising.

Tailor Your Environment to Your Needs

Making important areas and items more easily accessible can reduce the risk of falls or injuries, lowering the chance of developing bruises and improving your quality of life. Arrange your home in a way that’s easy to navigate, particularly in high-risk areas such as stairs or bathrooms. Make sure lighting is good so all areas are easy to see, especially at night.

Use Assistive Devices

Assistive devices, like canes and walking sticks, can provide much-needed support on days when your balance or depth perception are particularly altered.

Ask for Help When Needed

Instead of getting yourself into a situation that could put you at risk for falls or injuries, ask for help. Stairs, high shelves, and slippery floors can present dangers or increase the chance of injury and bruising. You may prefer to be independent and reluctant to ask, but seeking help at the right times can prevent pain and keep bruises from worsening.

Find Your Team

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Do you bruise easily with MS? Have you found ways to prevent or avoid bruises? Let others know in the comments below.