A: Interestingly, most people who come to my office check “Yes” in the “Bruises Easily” box on their intake form. A majority of these people also take nutritional supplements and eat healthy foods. This is good, but there are a few caveats when you’re going to have injections or surgery. Let me just mention that if you have any medical condition, check with your doctor before adding or subtracting anything from your diet or supplements. Always let your doctor know all medications and supplements that you take and never discontinue a prescribed medication, including aspirin, without checking with your doctor first. Bruising always goes away and nothing as elective as a cosmetic procedure is worth gambling with your health.
Now, why do we bruise? Bruising is basically a little blood leaking out of a blood vessel from a bump, scrape or nick. Our body has its own seal-it-off and clean-it-up team that clears bruises for us, usually over a matter of days to a week, but very occasionally bruises can last two weeks or longer. In the interim we can watch a bruise go through some charming color changes that generally can be concealed, especially once the bruise is looking more reddish than blue.
We’re built with an excellent blood supply to the head. Our brains and eyes (the eyes actually being extensions of our brains) require a tremendous amount of oxygen relative to the rest of the body to function properly. The good news is that all those blood vessels with their oxygen make it much more difficult to get an infection at the face than say, at the legs or feet. The other side of the coin is that we can be a bit juicy at the face even with a superficial scrape.
On top of that, every little millimeter on a face shows because the facial features are small compared to the rest of the body, so even a little bruise is a larger part of the whole picture. Plus, you can’t really throw a coat over it.
While I’m a big proponent of a vegan or vegetarian diet – better for you, better for the planet, certainly better for the animals – there is a whole list of mostly fruits and several veggies that can thin your blood and make you bruise more easily. I advise going easy on these foods for a prescribed amount of time before an injection or surgical procedure. Berries, grapes, citrus fruits, tomatoes or Omega-3 nutrition (like fish, fish oil or flaxseed) can thin the blood. Peas, corn, cauliflower, carrots and broccoli will not thin the blood. Bananas won’t either. Some of the more common supplements such as garlic, ginkgo biloba, St. John’s wort, grapeseed extract and cayenne can promote bruising. Your doctor can give you advice regarding your diet prior to a procedure. We have a comprehensive list we give to our patients.
Foods aside, the three major players regarding bruising are alcohol, aspirin and non-steroidal anti-inflammatory agents (e.g., ibuprofen as in Advil or Motrin, or naproxen as in Aleve or Midol). While no one will object if you skip martinis or wine for a while, let me stress again that you should never discontinue a medication your doctor has advised or prescribed without checking with her first. If a person is on blood-thinning medications such as Coumadin, Plavix or aspirin and we’re considering a surgical procedure, I will speak with the prescribing doctor and we’ll agree on the best advice for that individual.
If you’re having injections, cool compresses just before and after the procedure will help constrict the blood vessels so they aren’t as likely to bruise. The compresses also have a little numbing effect. After surgery on the face or neck, you will have a prescribed regimen that usually will involve using cool compresses and keeping your head elevated about 30 degrees from the horizontal.