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As you and your loved ones age, you may notice a tendency to develop large bruises, especially on the hands and forearms and seemingly out of nowhere.
Called actinic purpura, these large, flat, bruises start out dark red in color and change to brown, green, and yellow as they heal. Exposure to the sun over time and age-related changes to the skin set the stage for actinic purpura, which is triggered by an injury to the skin—even one so slight you can’t remember it happening.
Studies estimate that about 12% of people over age 50 and 30% of people over age 75 experience actinic purpura. It affects both genders equally. Actinic purpura can appear in people with any skin tone. It occurs more often in lighter skinned people because, on average, they tend to have more UV-related skin damage.
While actinic purpura does not cause severe health problems, it’s important to discuss skin changes with a dermatologist. Some symptoms of actinic purpura mimic other more complex conditions such as a platelet disorder or leukemia.
At Medstar Health, our dermatology specialists provide expert care to treat a wide range of skin disorders and conditions. We can help determine whether your condition is something more serious.
What causes actinic purpura?
Actinic purpura is sometimes called solar purpura because of it’s relationship to the sun. An outdated name for it is senile purpura because it is also related to aging. However, it’s both insulting and misleading since purpura is not associated with cognitive decline.
Sun exposure and aging both change the skin in ways that make it vulnerable to damage. Over time, the sun’s UV rays can cause connective tissues in the midportion of the skin to weaken, reducing its ability to support blood vessels.
Aging also causes skin changes, including the way fat is distributed under the skin that results in blood vessels shifting closer to the surface. As we age our skin becomes more fragile and thinner in some places, which can contribute to easier injury.
Other factors can increase your likelihood of developing actinic purpura, including some medications. If you’re on steroid-based medications for a long time because of an organ transplant, or blood thinners to prevent clotting, it’s likely your purpura could be more severe.
Related reading: Geriatrics and Senior Services
Is there treatment for actinic purpura?
Much like other sorts of bruises, there is no specific treatment for actinic purpura. The bruises will heal over time. Vitamin A-based retinoids, which are topical treatments, can help repair damage to the skin caused by sunlight in some patients.
Vitamin C and some other citrus-based elements haven’t been proven to be an effective treatment for actinic purpura. In patients with a vitamin C deficiency, which causes a weakening of the blood vessels, supplementing oral vitamin C could help. It has not been shown to improve healing in people who are not deficient.
Most patients who develop actinic purpura don’t get just one bruise, and the bruises can be unsightly. Some patients report feeling self-conscious about them, so it’s worth considering ways to prevent these bruises from appearing in the first place.
Related reading: Sunscreen, Safety, and Self-Exams: Tips to Reduce Skin Cancer Risks.
How to prevent actinic purpura bruises.
Once actinic purpura has developed, preventing skin trauma and reducing further sun damage are the best way to stop new bruises from developing:
- Wear protective clothing. Long-sleeved shirts designed for activities like gardening create a barrier to protect your most fragile skin from the world.
- Limit UV ray exposure. Sun exposure can be very damaging to the skin, and its impact accumulates over time. Wear clothes labelled with “UPF” or “Ultraviolet Protection Factor”, and apply and reapply sunscreen with an SPF of at least 50.
The sun and advanced age are also a major risk factors for developing skin cancer, so taking steps to prevent actinic purpura will have many other benefits for your health and your skin.
Actinic purpura can be unsightly, and while it’s not usually serious, talk with a dermatologist to protect your skin and mimimize age-related skin changes for overall health.
