Q. I’ve been getting bruises lately and I can’t remember hurting myself. Should I see a doctor?
A. A tendency to bruise easily is common when you age. It’s especially common among women.
A bruise — also known as a contusion — occurs when the tiny blood vessels under your skin break after being struck. When you bruise, the blood leaks under the skin and leaves a black-and-blue mark. The harder the impact, the bigger the bruise. As the blood is reabsorbed by your body, the bruise goes away.
You can enhance healing by elevating the injury and applying a cold pack for a half-hour at a time for a day or so after you are injured. Once there is no swelling, a warm compress can accelerate reabsorption.
Blood-thinning medications can contribute to bruising. So, you might bruise more easily if you take Plavix or Coumadin. Aspirin will have a similar effect. The thinners allow more blood to pool under your skin. If you’re taking one of these drugs, what seems like a harmless bump against a coffee table could lead to a nasty bruise.
Some dietary supplements can thin your blood, too. Be careful if you are consuming more than normal amounts of fish oil, ginkgo, ginger or garlic.
It’s easier to bruise if your skin is thin. With age, your skin becomes thinner and loses some of the fat that protects your blood vessels. Corticosteroids are known to make your skin thinner, so these drugs can make you more bruise-prone.
Aging capillaries contribute to bruising, too. Over time, the tissues supporting these vessels weaken, and capillary walls become more fragile and prone to rupture.
There is a special type of bruising known as “Bateman's purpura,” which usually is seen on the back of the hands and forearms. Unlike everyday bruises, the bruises you get with Bateman’s purpura are not tender and last longer. They start out red and become purple. They darken and then, in time, fade. They can last for weeks.
This condition, also known as “actinic purpura,” is usually seen in seniors. It is caused by blood vessel walls that have been weakened by years of exposure to the sun. In addition, the skin is sun-damaged and thin.
Daily application of alpha hydroxyacid lotions to the skin have been shown to increase skin thickness up to 15 percent in patients with sun-damaged thin skin. This occurs through the stimulation of collagen production, the skin’s natural support protein. For women, the hormone progesterone in lotion may also help.
Most bruises are not a cause for concern, but you should have bruising checked by a doctor if you are experiencing the following: unusually large or painful bruises, bruises that seem to have no cause, abnormal bleeding elsewhere, or sudden bruising after beginning a medication.
These symptoms may mean that you don’t have enough platelets in your blood. Platelets help your blood to clot.
You can take steps to prevent bruising from falls and collisions. Here are some:
1. Always hold the handrails on stairways.
2. Don't stand on a chair to get to something.
3. Clear floors where you walk.
4. Mount grab bars near toilets, tubs and showers.
5. Place non-skid mats, strips, or carpet on all surfaces that may get wet.
6. Put night lights and light switches close to your bed.
7. Tack down all carpets and area rugs.
8. Close cabinet doors and drawers so you won't run into them.
9. Be especially careful around pets.