Bruising and bleeding
Unexplained bruising and bleeding can be symptoms of leukaemia or other blood cancers. Find out why this is, and when to seek help.
Summary
- Bruising and bleeding are natural responses to injury. Most people who get bruising or bleeding do not have leukaemia.
- But unusual or unexplained bruising or bleeding can be a symptom of leukaemia or other types of blood cancer.
- If you have frequent or recurrent bruising or bleeding that you’re worried about, make an appointment with your GP and ask for a blood test.
About bruising and bleeding
Bruising and bleeding are natural responses to injury. Most of the time, they are normal and nothing to worry about. But unusual or unexplained bruising or bleeding can be a symptom of leukaemia and other types of blood cancer.
This might include:
- Bruising after very minor bumps, or when you can’t remember any injury at all. The bruises might be bigger than you’d expect, last longer, or cause a lump you can feel.
- Nosebleeds that happen often or last a long time.
- Bleeding gums.
- Bleeding more than usual from cuts or wounds. Or bleeding that takes longer than usual to stop.
- Bleeding after only minor trauma to the skin.
- Heavier periods than usual.
- A rash of tiny dots that doesn’t fade when you press on it. The dots look red or purple on light skin. They look purple or darker brown on black or brown skin.
- Blood in your poo, which could look bright red or black and tarry.
- Blood in your pee.
Photos of bruising and pinprick rash
A very large, dark bruise.
Bruising in an unusual place.
Multiple bruises.
A pinprick rash. You might hear doctors call this a petechial rash.
Up to 4 in 10 adults with leukaemia get unusual or unexplained bruising and bleeding. More than 6 in 10 do not.
Around 5 in 10 children with leukaemia get unusual or unexplained bruising. Around 5 in 10 do not.
Like all symptoms of leukaemia, bruising and bleeding can be caused by many things. Having these symptoms does not mean you definitely have leukaemia. But if you’re worried about your symptoms, it’s a good idea to see your GP.
Why do people with blood cancer get bruising and bleeding?
Bruising and bleeding in people with blood cancer is usually caused by low platelet levels.
Platelets are fragments of blood cells that help your blood clot. They grow and develop in your bone marrow.
If you have blood cancer, your bone marrow can get filled with cancer cells. This stops it making enough healthy blood cells, including platelets.
If you do not have enough platelets, your blood may not be able to clot properly. This leads to bleeding. If the bleeding happens underneath your skin, it causes bruises.
Sometimes, blood cancer can also cause problems with the proteins that help your blood clot. These are called clotting factors. If you do not have enough clotting factors, you might bleed or bruise easily. And bleeding can take longer than usual to stop.
What else can cause unusual bruising and bleeding?
Unusual bruising and bleeding can be caused by lots of things. Many people who get it do not have leukaemia.
Other things that can cause bruising or bleeding include:
- Injuries, especially if you are very active or play contact sports
- Some medicines, like aspirin, ibuprofen, steroids or warfarin
- Low vitamin levels
- Infections
- Inherited conditions such as haemophilia
- Liver problems
- Immune-mediated conditions such as immune thrombocytopenia (ITP)
People also tend to bruise and bleed more easily than they used to as they grow older.
When to seek help
Call 999 or go to A&E straight away if you have:
- An injury that won’t stop bleeding
- A nosebleed that lasts for more than 10 to 15 minutes
If you have frequent or recurrent bruising or bleeding that you’re worried about, make an appointment with your GP and ask for a blood test.
Nearly 4 in 10 people with leukaemia wait 3 months or more before contacting a GP about their symptoms.
Signs that you should contact your GP about bruising and bleeding include:
Bruises
- In unusual places, like your chest, tummy or back
- Lots of them
- Bigger than you’d expect
- You can’t explain how you got them
- Take longer than usual to heal
Bleeding
- Heavier than usual
- Happens frequently
- Takes a long time to stop
- Occurs after only minor trauma to the skin
If you have unusual bruising or bleeding and your GP can’t identify a cause, they should consider an urgent blood test. If they don’t offer you a blood test, ask for one.
If you are struggling to get help
Nearly 3 in 10 people with leukaemia have to speak to their GP three or more times before getting a diagnosis.
There may be many possible explanations for your symptoms for a GP to consider.
If you have to go back to your GP three or more times about the same symptom, remind them about Jess’ rule. This encourages GPs to ‘reflect, review and rethink’, particularly if:
- You still have the symptoms
- They have got worse
- They are unexplained
Take a look at our Spot Leukaemia campaign to find out what we’re doing to help the public and GPs spot the signs of leukaemia sooner.
Sources
Sources we used to develop this information
Black GB, Boswell L, Harris J, Whitaker KL. What causes delays in diagnosing blood cancers? A rapid review of the evidence. Primary Health Care Research & Development. 2023 Jan;24:e26. DOI: https://doi.org/10.1017/S1463423623000129
Chennamadhavuni A, Lyengar V, Mukkamalla SK, Shimanovsky A. Leukemia. StatPearls. Treasure Island, FL: StatPearls Publishing. 2023. Available at: https://www.ncbi.nlm.nih.gov/books/NBK560490/ [Accessed May 2026]
Clarke RT, Jones CH, Mitchell CD, Thompson MJ. ‘Shouting from the roof tops’: a qualitative study of how children with leukaemia are diagnosed in primary care. BMJ Open. 2014 Feb;4(2):e004640. DOI: https://doi.org/10.1136/bmjopen-2013-004640
Clarke RT, Van den Bruel A, Bankhead C, Mitchell CD, Phillips B, Thompson MJ. Clinical presentation of childhood leukaemia: a systematic review and meta-analysis. Archives of Disease in Childhood. 2016 Oct 1;101(10):894-901. DOI: https://doi.org/10.1136/archdischild-2016-311251
DiNardo CD, Erba HP, Freeman SD, Wei AH. Acute myeloid leukaemia. The Lancet. 2023 Jun 17;401(10393):2073-86. DOI: https://doi.org/10.1016/s0140-6736(23)00108-3
Doherty TM, Kelley A. Bleeding disorders. In: StatPearls 2023 Apr 03. StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK541050/ [Accessed May 2026]
National Institute for Health and Care Excellence (NICE). Clinical Knowledge Summary: Haematological cancers - recognition and referral. Revised 2025. Available at: https://cks.nice.org.uk/topics/haematological-cancers-recognition-referral/ [Accessed May 2026]
National Institute for Health and Care Excellence (NICE). Suspected cancer: recognition and referral. NICE guideline NG12. 23 June 2015; updated 25 April 2026. Available at: https://www.nice.org.uk/guidance/ng12 [Accessed May 2026]
NHS cancer programme: faster diagnosis framework. November 2022. Available at: https://www.england.nhs.uk/publication/cancer-programme-faster-diagnosis-framework/ [Accessed May 2026]
NHS England. National Cancer Patient Experience Survey 2024. Available at: https://www.ncpes.co.uk/latest-national-results/ [Accessed May 2026]
NHS Scotland. Scottish referral guidelines (SRGs) for suspected cancer: Haematological cancers. Available at: https://www.rightdecisions.scot.nhs.uk/scottish-referral-guidelines-srgs-for-suspected-cancer/haematological-cancers/ [Accessed May 2026]
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Page last reviewed: 10 September 2026
Updated September 2026
Next review due: 30 September 2029
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