Summer is here, you change into short sleeves and shorts, and you find yourself getting bruises on your legs and hands at some point. Their origins are mysterious, their appearance and disappearance seem elusive.
Why do girls always have bruises on their legs? Is this a symptom of anemia, or should you take a vitamin supplement?
A bruise on a leg, what is it?
Most bruises are normal. This is not because there is a problem with your nutrition, but because you are injured. For example, if you bump into it, but the degree is very light and the skin is not broken, you will not find it [1].
However, although this kind of minor injury does not break the skin, it does damage the blood vessels under the epidermis. The “bruises” we see are actually blood leaking after the blood vessels are damaged. color. Under normal circumstances, it is prone to occur in the arms, thighs, buttocks[1].
You may have seen cyan or even tan bruises, also because over time it has become more than cyan.
Blue is often more than one color / Wikimedia Commons
If your blood vessels are broken and blood leaks, the red blood cells and some free oxyhemoglobin initially appear red, and over a period of time, the red blood cells dissolve to form methemoglobin, and the color also changes. It turns brown and gradually reappears green (from biliverdin) and yellow (from bilirubin) [2].
However, if it’s just bruising, why is it more common in women?
Thinner skin, more visible bruises
Women are more prone to bruising than men, and there are biological reasons for this.
In the human body, in addition to the well-known red blood cells and white blood cells, there is another type of blood cell that is also crucial – platelets – which help maintain the integrity of the blood vessel walls.
When platelet counts drop, capillaries are more likely to break; when platelet counts drop to half the lower limit of normal, minor trauma, or even a mere increase in blood pressure, can damage blood vessels Ruptured with small bleeding spots.
Platelets are not only related to the fragility of blood vessels, but also to hemostasis after blood vessels are injured[3].
Structurally, women have weaker blood vessels and platelets than men, and are more prone to vascular and platelet diseases[4], and female Hormones, not only hinder the proliferation of a cell in the blood vessel wall, but also hinder platelet aggregation and adhesion [5].
In layman’s terms, when repairing the “wall” of blood vessels, estrogen does not allow platelets to help build bricks or putty.
This phenomenon sounds scary, but it’s actually good for girls. For example, acute myocardial infarction is caused by platelet aggregation and thrombus formation, blocking the blood vessels, resulting in myocardial ischemia [4]. Women are also less at risk of this type of cardiovascular disease than men.
Girls’ legs are less hairy and their skin is paler, so the bruises will be obvious
Image source: Zhanku Hailuo
But when damaged, this becomes a disadvantage. Estrogen is not good for blood vessel wall repair and blood clotting, and women are more prone to bruising than men.
Not only that, but bruising is more noticeable on women after bruising.
Human skin is divided into epidermis and dermis, the epidermis has an average thickness of only 0.1 mm, and the dermis is rich in capillaries [6].
Because men’s skin is generally thicker than women’s [7], that is to say, girls’ capillary damage and blood leakage are more obvious and easier to see.
There are some bruises that need your attention
But if you’re sure you haven’t been injured by an external force, but you still have bruises, or bruises that don’t appear in common locations like arms, legs, buttocks, etc., it may be pathological , it is worth noting.
The most common cause of pathological bruising in women is an abnormal platelet count or function.
Thrombocytopenia may be associated with a variety of underlying blood disorders, because platelets fail to produce or are destroyed [1]; while platelet function abnormalities, most commonly due to drugs such as aspirin, High intake of alcohol for a long time is also one of the reasons [1].
Long-term alcohol consumption also reduces platelet procoagulant activity
Image source: Zhanku Hailuo
Also, the duration and severity of the bruise are important. If you have barely seen a bruise on your body before, but it has recently appeared frequently, it is also cause for concern, and if necessary, seek medical attention as soon as possible to determine whether it is related to platelet or coagulation disorders [1].
If there are often bruises on the arms and legs, and other parts are prone to bleeding, it may also be psychogenic purpura, also called Gardner-Diamond syndrome. Red blood cell allergy [8].
Blue, yellow, and green ecchymoses on the arms of patients with psychogenic purpura / Silny, W., Marciniak, A., Czarnecka-Operacz, M., Zaba, R. , & Schwartz, R. A. (2010). Gardner-Diamond syndrome. International journal of dermatology, 49(10), 1178–1181.
Of course, the cause of a bruise may be less complicated.
If there are people around you who are usually in good health, but only have intermittent bruises, especially bruises in places that are not easy to bump, or even accompanied by abrasions, then you should take it seriously— It is likely to be behind domestic violence [1], which requires the joint help of doctors and society.
However, in general, most bruises are normal and should not be taken too seriously. Next time you see a bruise on your calf, remember to be gentle with your legs.
This article is reproduced with permission from the answer below
This article reviewer
Kingdom Rong
Deputy Chief Physician of Hematology
Beijing Chaoyang Hospital Affiliated to Capital Medical University
References
[1]Garvey B. (1984). Easy bruising in women. Canadian family physician Medecin de famille canadien, 30, 1841–1844.
[2]Jeney, V., Eaton, J. W., Balla, G., & Balla, J. (2013). Natural history of the bruise: formation, elimination, and biological effects of Oxidative hemoglobin. Oxidative medicine and cellular longevity, 2013, 703571.
[3] Editor-in-Chief Wang Tinghuai. (2018). Physiology (9th Edition). Beijing: People’s Medical Publishing House.
[4]Ge Junbo, Xu Yongjian, Wang Chen, editors. (2018). Internal Medicine (9th edition). Beijing: People’s Medical Publishing House.
[5]Joswig M. (2000). Wirkungen von Ostrogenen auf die Gefässwand: Zelluläre und molekulare Mechanismen [Effects of estrogens on the vascular wall: cellular and molecular mechanisms]. Zeitschrift fur arztliche Fortbildung und Qualitatssicherung, 94(3), 189–193.
[6] Zhang Xuejun, Zheng Jie, editor-in-chief. (2018). Dermatology (9th edition). Beijing: People’s Medical Publishing House.
[7]Escoffier, C., de Rigal, J., Rochefort, A., Vasselet, R., Lévêque, J. L., & Agache, P. G. (1989). Age-related mechanical properties of human skin: an in vivo study. The Journal of investigative dermatology, 93(3), 353–357.
[8]Sarkar, S., Ghosh, S. K., Bandyopadhyay, D., & Nath, S. (2013). Psychogenic purpura. Indian journal of psychiatry, 55(2), 192 –194.
Planning
Producers: Ta Gai, Feidi
Cover image source: Zhanku Hailuo