Bruise School
What Is a Bruise?
A bruise is a visible mark on the skin caused by small blood vessels breaking under the surface. When this happens, blood leaks into nearby tissue and becomes trapped, creating discoloration that can range from red or purple to blue, green, yellow, or brown as it heals.
The medical term for the purple, often large, and seemingly spontaneous bruises that appear on the skin of older adults is Senile Purpura (sometimes called Actinic Purpura or Bateman’s Purpura). The purple bruises common in the elderly are the result of the natural, cumulative aging and sun-damage process that makes the skin and its tiny blood vessels fragile.
Why It Happens (The Underlying Causes)
It’s not a disease in itself, but a sign of age-related changes in the skin and blood vessels:
- Thinning Skin (Atrophy): With age and cumulative sun damage (photo-aging), the epidermis (top layer) and the dermis (supportive layer underneath) become thinner. The protective fatty layer that cushions blood vessels also diminishes.
- Weakened Blood Vessels: The collagen and elastin fibers that support the walls of tiny blood vessels (capillaries) degrade. This makes the vessels fragile and prone to breaking easily.
- Reduced Tissue Support: The thinner, less elastic skin provides less support to the capillaries. A minor bump can cause a vessel to tear and leak blood into the surrounding tissue.
Important Notes:
Not usually a sign of a serious bleeding disorder: While senile purpura is primarily a structural skin issue, it can sometimes be confused with or exacerbated by other conditions. Easy bruising can also be a side effect of medications (e.g., blood thinners like aspirin, warfarin, or even steroids and some NSAIDs).
When to See a Doctor: It’s generally benign, but medical advice should be sought if:
- Bruising appears suddenly and severely without any cause.
- Bruises are very painful and swollen.
- Bruising is accompanied by bleeding from the gums or nose.
- There is a family history of easy bleeding or bruising.
- The person is on new medications.