Former US President Donald Trump’s recent remarks about bruising caused by taking “big aspirin” have brought renewed attention to a long-standing medical question: how safe is aspirin, especially at higher doses, and why does it cause visible bruising in some people?
After addressing reporters about a bruise on his hand, Trump attributed it partly to aspirin use, noting that he takes a full-strength 325 mg dose despite doctors telling him it may not be necessary. His comments reflect a common belief that aspirin is a harmless preventive medicine—but cardiologists warn it is a powerful drug with clear risks.
Explaining the science behind aspirin-related bruising, Dr Rahul Sharma, Additional Director of Cardiology at CK Birla Hospitals, Jaipur, said aspirin works by inhibiting platelets, the blood cells responsible for clot formation. This anti-platelet effect is what makes aspirin effective in preventing heart attacks and strokes, but it also reduces the body’s ability to stop minor bleeding.
“When platelet activity is suppressed, even small bumps or unnoticed trauma can cause blood to leak into surrounding tissues, leading to visible bruises,” Dr Sharma said. These bruises may appear larger or darker than usual, even without significant injury.
Age further increases the risk. As people grow older, skin becomes thinner and blood vessels more fragile. Many older adults also take additional medications such as blood pressure drugs or other blood thinners, which can amplify aspirin’s bleeding effects.
While low-dose or “baby” aspirin (75–81 mg) carries a lower risk than full-dose aspirin, bruising can still occur. Individual sensitivity varies widely, making self-prescription particularly risky. Doctors now stress that aspirin is no longer routinely recommended for primary prevention of heart disease, especially in people without established cardiovascular conditions.
Experts say alternatives such as statins, blood pressure control and lifestyle changes often provide strong heart protection without the same bleeding risks. Aspirin, they emphasise, should only be used when the benefits clearly outweigh the risks.
Trump’s remarks may have been casual, but they underline an important medical reality: bruising is not just a cosmetic issue, it signals the same mechanism that can increase the risk of serious bleeding. Aspirin can be life-saving when used correctly, but unnecessary use can do more harm than good.
