AARP Hearing Center
I Bruise Easily. Should I Be Concerned?
A doctor’s advice about why frequent bruising occurs and when you need to worry
James Yates
I seem to bruise more easily these days. Should I be worried?
I would say this is one of the top 10 concerns patients mention to me during their physical exam. Every day, I hear, “What’s going on with my skin, Dr. Adam?” “Look at this awful bruising!” And I get it. It’s usually only a cosmetic issue, and there’s nothing serious to worry about. But bruising makes us look and feel older — especially on our hands, where we tend to notice those dark red and purplish marks most often. That said, less than a quarter of older adults with accidental bruises remember how they got them in the first place.
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No matter how it happens, bruises are the result of blood that pools either in or under our skin. Older folks are more likely to experience this condition. One reason is that as we age, our skin naturally loses collagen and elastin, the proteins that keep it firm and springy. Mature skin is also thinner and more fragile, making it prone to bruising and slower to heal. In contrast, when you’re younger, you have a hat trick of protection: stronger blood vessels, thicker skin and a cushy layer of fat.
Certain medications, in particular blood thinners, aspirin, ibuprofen (Advil) and naproxen (Aleve), as well as corticosteroids and some antidepressants and antibiotics, can increase the risk of bruising. What’s more, if you were chasing a tan in your youth, it’s likely that those years of sun exposure further damaged your skin and blood vessels. Some vitamin and mineral conditions, like iron or vitamin E and K deficiencies, can make you more susceptible to skin injuries. Dehydration may also contribute to the problem.
Diabetes affects bruising, too. Why? Because one of the hallmarks of this disease is poor circulation, which leads to reduced blood flow to the tissues. When this happens, the body takes longer to heal.
Although it’s pretty rare, easy bruising can be a symptom of something more serious. If you find large marks on your chest, stomach, back or face that seem to happen for no reason, don’t wait to let your doctor know. It could be a sign of an underlying condition, like a type of cancer or an autoimmune disease like lupus or rheumatoid arthritis.
A larger dark spot can also be the sign of a subcutaneous hematoma, a pooling of blood just under the skin due to a leaking blood vessel. Bruises tend to be flat and tender to the touch, while hematomas tend to be raised, hard and painful. Hematomas may require medical treatment, so if you’re not sure whether you have a bruise or hematoma, be sure to have your doctor take a look.
To make sure there’s nothing to worry about, your doctor may give you a physical examination and ask questions about your symptoms and medical history. And if there’s further concern, the physician might check your blood platelet levels — platelets are the part of blood that helps it clot after an injury — or run tests that measure how long it takes your blood to clot.
The welcome news is that some simple daily habits can bolster your skin’s resilience. A healthy diet will help you to produce collagen, strengthen blood vessels and heal more quickly. Eat plenty of foods that are rich in vitamin C, K and the mineral zinc. Good sources of these nutrients include citrus fruits, blueberries, leafy greens, bell peppers, nuts, legumes, seeds, sardines, poultry and whole grains.
What else? You’ll want to wear protective clothing, like long sleeves, during activities. Moisturize regularly to maintain your skin’s elasticity. And don’t underestimate strength training. Even light resistance work helps maintain muscle tone, which cushions those tiny blood vessels.
Prevention may not erase every bruise, but it can certainly turn down the frequency. While bruising may be more common as we age, it’s not something you simply have to accept without question. Paying attention to skin damage when it appears, reviewing medications and making small changes in your daily routine can go a long way toward protecting your skin and your self-confidence. Thin skin doesn’t have to mean we’re marked for life.
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