My Thin, Aging Skin: Hands and Arms That Bleed and Bruise Easily
The Sun Takes Its Toll
Sun-exposed forearms and hands in elderly individuals results in Bateman's purpura, or BP. Bruising is caused by blood vessels weakened by sun exposure. Ultraviolet light is the causative part of the spectrum. Minor impact to the skin can cause bruising. Other terms include solar purpura, actinic purpura, and senile purpura.
My interest in this subject stems from not wanting to limit my activity—which I think is a concern to many people who are aging. I don't want to miss out on life because of concerns about banging up my skin. Throughout this discussion, I want to refer to what happened to me and how I addressed the problem.
At 62, I am a classic example of a person who should have taken better care of himself. I have lived in Arizona since the age of five. Fifty-seven years of improper skin protection has taken its toll. I took warnings about using sunscreen with a grain of salt. I was too busy to fuss with all of that, I thought! More often than not, I wore short-sleeved shirts outside in the intense summer sun.
Once I reached my 50s, however, I began to notice that very small bumps and bangs could cause deeper cuts and more bleeding than I was accustomed to. I began to learn about the concept of thinning skin, and I started to do something to protect myself.
One of the troubling results of aging is the acquisition of paper-thin skin. This "thin skin" is due to a reduction in the amount of collagen (a protein, fibrous in nature, connecting and supporting other bodily tissues) under the surface of the skin. Elastin (another protein), which gives flexibility or spring to the skin, also decreases. Exposure to the sun and its ultraviolet rays accelerates the loss of collagen and elastin. Because the hands and forearms are the most frequently uncovered parts of our body, the thin skin develops there most often. The skin changes in appearance, doesn't bounce back, and tears and bruises more easily.
Thin Purple Skin
With thin skin, bumps and bangs usually cause an immediate bleed under the skin if not broken. These purple marks spread out under the skin and are a telltale sign of age. I look at them now as if they were scars, and the people I have them with in common, veteran livers. It wasn't always so.
The interest I took, noted earlier, came from the surprise when I discovered a big blood spot or found blood on clothing. Usually, I am unaware that anything happened to cause such a bruise or bleed. There is nothing heartwarming about working on a project, discovering blood, and then trying to find out where it is coming from!
An example may be informative to the younger. I work on cars. I cannot say I enjoy it, but I must repair cars out of necessity. The automobile is the single biggest cause of nicks and bruising on my body. When I am done repairing something on an automobile, I have looked as if I have been through some kind of war. My skin, having traveled across a piece of metal or some kind of connector, ever so slightly, came up a loser. Usually, blood was smeared all over part of the engine or all over me. With nicks and bruising all over, I realized I had to make a lifestyle change.
So here is an idea that my wife, not I, came up with. She suggested that I wrap dish towels around my arms and secure them with rubber bands (not tight rubber bands!). Over that, she felt I should wear a long-sleeve shirt to keep them in place and help protect my arms and hands from the rough environment and the sun! She is a smart lady.
Since doing this, I have virtually eliminated cutting to my skin. I still get some bruising, but nothing is perfect. I am so grateful for this suggestion she made. And for those of you out there who don't FEEL old yet and want to continue with what you have always done, this is something that helps me with car repairs.
I use this cream to lessen the spread of the bruise, rather than taking an oral vitamin K at my age.
Dish towels rubber banded around the forearms covered by a long sleeve shirt can be a very inexpensive fix. I am including photos. The dish towels run $4 for six at Walmart. I use latex gloves to protect my hands from cutting (but they are also now recommended for professional auto repair people to prevent cancer from over-exposure to burned hydrocarbons). I get Medi Touch Powder Free Latex Gloves, 50-count per box at $6.27 at Walmart.
Another example of a common thing I do to get an abrasion involves yard work. My home is made of frame and stucco—the outer coat is a rough Spanish lace texture. If I turn a corner just a bit too soon and my forearm touches that rough stucco, I have a scrape that will bleed. This is the kind of scrape that used to appear as roughed-up white dry skin, perhaps a little reddened but not bleeding.
If I get close enough to a countertop to tap it with my hand or forearm, it can result in a bruise or a nick. So here is a common sense solution I have had to acknowledge and use to change my behavior. I have had to become more careful. As easy as it seems, it takes some training. I intentionally give more room between me and objects. If I see a countertop, I don't get as close. If I see a corner, I remind myself to make a wider turn. These are things I never consciously thought about before; the consequences of hitting were not very serious.
Grandpa's First Aid Tips
I deal with bloody spots under the skin with vitamin E gel. I use Equate Aloe Vera & Vitamin E Baby Oil Gel. Before bed every evening, I wash the area with the bloody spot and apply the gel, which rubs in and disappears quite well. What have been the results? I think the gel helps the bruise dissipate sooner. I cannot prove it scientifically, but it is something I believe is working. My skin also feels better. Maybe it would help you, too? Again, I have my wife to thank for the idea. She is an aloe convert and has seen its healing properties in other ways - for her, in the treatment of sunburn. She thought the gel might help my forearms and hands. I am a convert. The gel costs around $1.50 per tube at Walmart.
If I get a nick doing ordinary chores or activities, I wash them and apply an antibiotic ointment. While at the doctor's office for a routine check-up, my physician noticed my little cuts and bruises and emphasized that I should clean them immediately and apply such ointment or cream. She told me that I was at risk of an MRSA (Methicillin-resistant Staphylococcus aureus) infection if I ignored it, which I used to do. MRSA is a bacteria that is getting resistant to a number of antibiotics. Cleaning and treating immediately get ahead of it. Remember when you would scab in 5 seconds, ignore the wound, and continue to work? Not so smart anymore. I use Equate Triple Antibiotic Ointment at $2.52 a tube, which contains Polymyxin B sulfate—bacitracin zinc—gramicidin. There are other antibiotic ointments available. Inquire with a pharmacist.
So, to review, wear long-sleeve shirts to cover the forearms; this helps buffer the skin from nicking and bruising, and it also protects the skin from exposure to ultraviolet sunlight. Try using dish towels wrapped around the forearms to protect from cutting and bruising when working in tight quarters. Treat cuts and abrasions immediately with triple ointment or cream to prevent infection and to promote faster healing.
Vitamin K cream promotes blood clotting. At the moment of injury, applying it can reduce the amount of bleeding and, hence, the size of the blotch. Prices on Amazon start at $4.99 for 4 ounces, and the price goes up from there. I have not used this but read about it while doing research for the article.
And now for a final suggestion. I like to use Curad non-stick pads (12-count, 2"x3") with adhesive tabs for covering those little nicks (or gashes!). These pads stick less to the wound (the advertisements say they do not stick at all; I'm not sure that is completely true, but they are good, nonetheless). The pads provide a buffer, again, between the wound and the possibility of re-injuring the wound. I know those of you out there who are of age have had a cut stop bleeding, washed it, and returned to work only to find a few minutes later you have rapped the same cut again. Ouch! It almost always is a bigger tear with more bleeding. I am sure we have all seen the same thing. The Curad pads help a lot to keep the second strike from causing as much damage, and they cover the wound to prevent infection. The adhesive used by these pads has not torn my skin. It is an adhesive that grabs, but it doesn't grab so hard that you rip the skin when removing the pad. They are available for under $3.00 per box at Walmart.
I have personally decided to wait for a more serious health problem later in life to limit my activity. The bruising and cutting I experience due to thin skin is a bother, but it can be nullified in the bigger scheme of things. Don't let paper-thin skin hold you back!
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