'I bruise much more easily than I used to'
In the past few years, I have noticed that I bruise much more easily than I used to. It really bothers me. My arms and shins sometimes look black and blue. I feel people might be looking at me funny so I cover them up. Why is this happening? Is there anything I can do? I'm 78.
Firstly, bruising is common as people get older. I can understand how you would feel self-conscious but many of your friends are probably experiencing the same problem.
A bruise is the bursting of small blood vessels that lie beneath the skin. There are many causes for bruising.
With age, the skin becomes thinner and less hydrated. Consequently, the small vessels that lie beneath the skin burst easily.
Excessive exposure to the sun's UV rays accelerate this process, which means that you are more likely to bruise on the very areas that you would traditionally have preferred to leave exposed -- hands, legs, face.
As you age you also lose fat over the face, arms and shins. Fat provides excellent padding for the blood vessels that lie beneath the skin.
Medication often increases the likelihood of bruising. Aspirin prevents a clot occurring in the major blood vessels of the heart (heart attack) and the blood vessels in the head (stroke). Its benefit, however, comes with a price. By reducing the body's stores of clotting molecules it makes someone more likely to bleed.
Warfarin causes bruising through a similar mechanism. If you are on these agents, bruising is a small price to pay for the prevention of a stroke or heart attack.
Steroids will cause thinning of the skin thus potentiating bruising.
Some conditions increase the likelihood of bruising. Diabetes, thyroid disease and adrenal gland problems are examples. If you're concerned that you may have one of these conditions then consult your GP.
Some disorders of the blood may also lead to bruising. A simple blood test by your GP will rule most of these out.
My advice is to recognise that this condition is very common. If you are on aspirin or Warfarin I strongly suggest you stay on them. A check-up, however, might be worthwhile as your easy bruising may be a sign of an underlying disorder.
Dr Dan Ryan, specialist registrar in strokes and geriatric medicine, St James's Hospital, Dublin
ageing@independent.ie
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