Myth: Lipedema causes easy bruising
The Myth Explained
One widely repeated claim about lipedema is that it causes easy bruising, or that women with lipedema are especially prone to developing spontaneous, unexplained bruises — often without any noticeable trauma.
This idea is shared in many online support groups and is sometimes included in patient-facing resources or social media posts.
Some clinicians have also repeated this claim, referring to increased “capillary fragility” as a common feature of lipedema.
It is understandable why this myth has taken hold: when limbs are sensitive, painful, and enlarged, any minor trauma may feel amplified. Patients may notice bruises more frequently and associate them directly with lipedema.
The Facts
1. There is no evidence that lipedema increases bruising
Many women with lipedema do not bruise easily, and many people who do bruise easily do not have lipedema. That’s why easy bruising is no longer considered a diagnostic sign.
According to the S2k Guideline on lipedema (2024), easy bruising is not a symptom supported by current evidence. The guideline explicitly addresses this claim:
“The phenomenon of ‘bruising’ often reported by patients is not specific for lipedema and may be caused by other factors. There is currently no scientific evidence of increased capillary fragility in lipedema.” (S2k Guideline, 2024, Section 2.2.2, paraphrased)
In other words, the occurrence of bruises in patients with lipedema is not a characteristic feature of the disease, nor is it caused by any known structural changes to the blood vessels.
2. Capillary fragility is not increased in lipedema
Despite repeated claims, no histological or imaging evidence has demonstrated abnormal fragility of capillaries or increased microvascular permeability in lipedema.
Bertsch and Erbacher state clearly in their review:
“There is no data to support increased bruising in lipedema. The theory of capillary fragility is not supported by any peer-reviewed evidence.”
(Phlebologie 2018: Lipedema – Myths and Facts, Part 1)
- (For healthcare professionals, see also: Erbacher G, Mendoza E, Bertsch T: Thigh swelling in patients with lipedema – subjective perception versus objective examination. Letter to the editor, VASA, Online Veröffentlichung: November 07, 2022; Vasa Jahrgang 51, Heft 601 Nov 2022, 386-388. https://doi.org/10.1024/0301-1526/a001033 )
It is argued that what patients interpret as easy bruising may be due to:
- Minor trauma not consciously remembered
- Increased awareness of skin changes
- Normal bruising misattributed to lipedema
Importantly, such bruises do not distinguish lipedema from other conditions and are not reliable as a diagnostic criterion.
3. Easy bruising should prompt evaluation for other causes
In clinical practice, easy bruising may be caused by:
- Use of medications (e.g. anticoagulants, aspirin, corticosteroids)
- Nutritional deficiencies (e.g. vitamin C or K)
- Age-related changes in skin and vessels
- Other haematological or connective tissue disorders
If a patient presents with frequent or spontaneous bruising, these should be explored first, rather than assuming lipedema is the cause.
Q&A for Patients
You are not imagining what you see or feel. But it’s important to know the difference between what’s common and what’s caused by lipedema. Knowing the facts empowers you to avoid unnecessary treatments and get the right support.
- I bruise easily — doesn’t that mean it is caused by my lipedema?
No, it does not. While some people with lipedema report bruising, there is no evidence that lipedema causes this. Many women bruise easily for unrelated reasons.
- Why do I notice more bruises now than before?
Pain, increased limb volume, or greater attention to your body can all make bruises feel more visible or memorable. This doesn’t mean the condition itself is causing them.
- Should I be worried about easy bruising?
If you’re bruising easily or without cause, it’s worth checking with a healthcare provider. There may be another explanation that requires attention.
Futher Reading for Healthcare Professionals
From the ILA Co-Presidents
“As ILA, we stand for providing evidence-based information to support healthcare professionals and women with lipedema in achieving the best possible diagnosis and treatment. We are committed to dispelling misinformation, and we encourage open dialogue that reflects diverse perspectives to move science forward.”
– Ad Hendrickx and Gabriele Erbacher, ILA Co-Presidents, September, 2025.