What Do ITP Bruises Look Like?

Tiny pink dots around your eyelid. A small black-and-blue galaxy on your thigh. Purple splotches down your back. Bruising is one of the most common symptoms of immune thrombocytopenia (ITP), a condition that causes low platelet counts and increases the risk of bleeding.

If you’re living with ITP and develop a bruise, you may wonder whether they’re from the condition, a normal response to sustaining an injury, or something else.

In this article, we’ll look at the different types of ITP bruises, what causes them, what they may look and feel like, and how you can manage them.

How Does ITP Cause Bruises?

ITP is a disease that lowers the amount of platelets in your blood. Platelets are cell fragments that help blood clot. Fewer platelets lead to a number of ITP symptoms, including:

• Bruising
• Prolonged bleeding after an injury
• Blood in your urine and stool
• Heavy menstrual bleeding
• Bleeding gums

When you partake in normal activities, such as cooking, cleaning, or going out with friends, you may notice that you bruise more easily and severely than the average person. Most of the time, you may not even remember anything that may have caused it.

An increase in bruising may be a sign that platelet counts have dropped. The lower your platelets, the worse your symptoms may be. However, it’s important to keep in mind that many factors can worsen bruising, including the location and underlying causes of the bruise and your body’s ability to heal.

It’s important to monitor your symptoms and communicate any changes or concerns with your healthcare provider. The only way to know the severity of your ITP is through blood and other laboratory testing.

Do ITP Treatments Cause Bruising?

ITP treatments that can cause bruising include:

• Corticosteroids
• Intravenous immunoglobulin (IVIG)
• Immunosuppressants
• Rituximab (sometimes prescribed as an off-label treatment for ITP)
• Thrombopoietin receptor agonists
• Platelet transfusion (a procedure used in emergency situations)
• Spleen tyrosine kinase (SYK) inhibitors
• Bruton’s tyrosine kinase (BTK) inhibitors

Most ITP treatments help reduce symptoms and bruising by increasing platelet counts or slowing down platelet destruction. However, long-term corticosteroid use can thin the skin and make bruising happen more easily. Newer ITP treatments like SYK inhibitors or BTK inhibitors can cause unusual bruising or bleeding for some people.

Other types of ITP treatment may cause skin symptoms that appear like bruising. For example, a platelet transfusion or IVIG may cause a rash in some people. A rash may look different from a bruise, but appearance and symptoms vary.

Speak to your doctor if you experience side effects of your ITP treatment or if you think that it’s not working well enough to control your symptoms.

What Color Are ITP Bruises?

Bruises caused by ITP generally look like other bruises. Depending on your skin tone, a new bruise may appear red, purple, blue, black, or darker than the surrounding skin.

As the body breaks down the blood trapped under the skin, the bruise often changes color over time. It may turn green, yellow, or brown before eventually fading away.

Because bruising may be harder to recognize on certain skin tones, pay attention to other possible signs, such as:

• Tenderness
• Swelling
• Raised areas

If you notice new or worsening bruising, especially along with other bleeding symptoms, contact your healthcare provider.

Types of Bruises

There are many kinds of bruises that are commonly found in people with ITP. Learning the different types can make it easier to discuss symptoms with your healthcare team.

Purpura

Purpura is a type of bleeding under the skin that appears as purple, red, or brownish patches. It’s commonly seen in people with ITP and occurs when small blood vessels leak blood into the skin. Purpura can range from small spots to larger patches that are smaller than bruises.

Petechiae

Petechiae are tiny, red, purple, or brown pinpoint spots caused by bleeding from very small blood vessels. They’re often smaller than purpura, commonly appear on the lower legs, and may even resemble a rash.

People with more severe ITP may be more likely to develop petechiae, although it can still appear at any stage.

Ecchymosis

Ecchymosis, the medical term for bruises, occurs when bleeding collects under the skin, usually after a minor injury or bump. Everyone bruises at some point in their life, regardless of if they have ITP.

Ecchymoses are often larger than petechiae and may appear blue, purple, black, or brown depending on skin tone. They might also feel tender or sore, and in some cases, they may look raised or swollen.

People with ITP may develop ecchymoses more easily and from less force than people without low platelet counts.

What Do Bruises Feel Like?

Bruising in ITP can feel different for each individual. In general, bruises caused by low platelet counts from ITP may feel tender or sore to the touch like other bruises. The amount of pain or discomfort associated with a bruise can vary depending on the location, size, and severity of the bruise.

In addition to bruising, people with ITP may experience other symptoms related to low platelet counts, such as nosebleeds, bleeding gums, and heavy menstrual bleeding.

In severe cases, internal bleeding can occur, which can cause symptoms such as blood in the urine or black or tarry stool.

Ways To Manage ITP Bruising

To prevent bruising while living with ITP, you can try the following:

• Avoid activities that increase your risk of injury.
• Wear appropriate protective equipment during sports or higher-risk activities.
• Don’t take medications that increase bleeding risk, such as ibuprofen or aspirin, unless your healthcare provider recommends them.
• Take ITP medications as prescribed.
• Keep regular appointments to monitor platelet counts.
• Talk to your healthcare provider if bruising becomes more severe or lasts longer than usual.

If your symptoms are difficult to tolerate or are interrupting your life, talk to your doctor. There may be additional treatment options that could help reduce bruising and other symptoms. It’s important to communicate with your doctor about all potential symptoms and side effects.

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On myITPteam, people share their experiences with immune thrombocytopenia, get advice, and find support from others who understand.

What do your ITP bruises look like? Let others know in the comments below.