Health & Wellness

Bruises: What’s Normal and When Should You Worry


elderly-woman-looking-bruised-arm

Even the least clumsy among us ends up with an inexplicable black and blue mark once in awhile. And if it feels like you’re bruising more and more every year … you may be right. “Skin gets thinner as we age, making us more prone to bruising,” confirms Roper St. Francis Physician Partners internal medicine doctor Kopriva Marshall.

What’s a Bruise?
Bruises occur when blood capillaries near the skin’s surface are broken due to trauma—whether that’s a light bump against your bed frame or a more serious spill. “As the skin’s exterior thins and the cushion of fat between outer skin layers and inner layers containing blood vessels gets smaller, injury is more likely to occur,” she explains.

Another common contributor to seniors’ increased rates of bruising? Blood thinning medications, which reduce the ability of blood cells to clot, or clump together, and stop bleeding. According to Dr. Marshall, the most common is baby aspirin, which many older adults take daily for stroke prevention. While occasional bruises are completely normal, she says if you notice an abrupt increase in the amount or severity of them, talk to your doctor, as excessive bruising can be a sign of certain medical conditions, such as leukemia, liver disease, or hereditary blood disease.

How to Prevent and Treat Bruises
Though there’s no magic way to prevent bruises—“aside from being more graceful,” Dr. Marshall laughs—you can take precautions to stave off bumps and falls around the house. Avoid clutter, throw rugs, and loose electrical cords; install handrails where appropriate; and take caution when sitting down and standing up. When those inevitable bumps do occur, a cold compress can help reduce swelling within the first half hour and acetaminophen (Tylenol) can relieve pain without inhibiting blood clotting.

Time for a Checkup?
“Increased bruising is considered a normal part of aging when it is slow and progressive,” says Dr. Marshall. However, if you notice an abrupt increase in bruises, visit your doctor, who may test for certain blood problems and conditions.

Also seek help if:

  • Additional symptoms are present. If excessive bruising is accompanied by abnormal symptoms like bleeding gums or large, discolored patches of skin, pay a visit to your doctor, says Dr. Marshall.
  • Bruises occur in unexpected locations. “Bruising on the legs or arms is fairly normal,” says Dr. Marshall. “But if you start to see spontaneous marks on the abdomen, back, thorax, or face, it’s time to talk to your doctor.”
  • You have difficulty healing. If a bruise has not improved after two weeks or cleared after a month, make an appointment to see your physician.

By Jacqui Calloway

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