As a dermatologist, my cardiology colleagues commonly ask me for help in dealing with patient questions about bruising. Cardiologists inherently see more elderly patients than young ones and bruising can be very common as we age. This patient population is often present with noticeable and unsightly bruises, especially on their extremities. As a side note, in rare occasions unexplained bruising could be a sign of a more serious problem and you should not be afraid to discuss that with your doctor.
Most bruises form when small blood vessels called capillaries, which are near the skin’s surface, are broken by a minor (or major) impact to the skin. When this happens, blood leaks out of the vessels and initially appears as a bright red spot which can quickly appear purple or even black. Eventually, your body is able to reabsorb this blood that was trapped outside the vessel, and the mark usually slowly disappears, although, a bruise mark can leave a dyspigmented brown spot in its place.
As you get older, several factors may contribute to increased bruising, including aging capillaries.
Over time, the tissues that support these vessels weaken, and the capillary walls become more fragile and prone to rupture. Also, thinning skin is a major contributor; with age your skin becomes thinner and loses some of the protective “fatty” layer that helps cushion your blood vessels against injury. Excessive exposure to the sun accelerates the aging process of the skin. Many patients state that they have no recollection of any trauma to their skin – they just suddenly have a bruise for no explainable reason.
Also, a cardiologist’s patients are commonly on blood thinning drugs such as aspirin, warfarin, or Plavix. These medicines reduce the blood’s ability to clot. Because of this, bleeding from capillary damage that would normally stop quickly may take longer, allowing more blood to leak out and cause a larger bruise. These older patients tend to be on medications for other inflammatory conditions such as arthritis, as well. These medications called NSAIDs (nonsteroidal anti-inflammatory drugs) and corticosteroids can cause the skin to thin, making it bruise easier. And certain dietary supplements such as fish oil and ginkgo may increase your bruising risk since these supplements have a blood-thinning effect. As frustrating as this type of bruising can be, these above-mentioned medications are important to treat critical conditions and should not be stopped without discussing the necessity of them further with your doctor.
To help prevent the appearance of these bruises, you should keep your skin well moisturized and protected from the sun. You can also begin a topical therapy using a bruise treatment that contains ingredients such as Arnica Montana to help the body reabsorb the blood and Canadian Willowherb to reduce inflammation. Follow this with a conditioning product that includes ingredients to strengthen the skin on the surface and refortify the deeper layers to protect these fragile capillaries. This therapy, using the right products, can help restore the skin’s natural ability respond to bruising.