Why it’s easier to bruise as you age and what to do about it

There are several reasons why older adults bruise easily, but most are preventable.

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Anyone can get bruised from a hard blow, bump, or fall. But with age, these spots can appear more easily.

A bruise occurs when the shock of an injury ruptures small blood vessels (called capillaries) near the surface of the skin. According to the Mayo Clinic, ruptured capillaries can cause bleeding under the skin, which appears as a bruise. The bruise will subside as blood from the ruptured capillaries is reabsorbed into the body—a process that usually takes one to two weeks.

Here’s why bruising becomes more common with age, and what you can do to avoid bumps.

Why are older adults more likely to bruise?

Physiological differences in older adults make them more prone to bruising, but lifestyle factors can also play a role.

The production of the protein collagen slows down with age. The body also loses some of the protective fat that sits under the skin and acts as a buffer. This causes the skin to become thinner, more fragile, and more prone to bruising, explains Sharon Allison-Ottey, MD, geriatrician and member of the Healthy Women’s Women’s Health Advisory Committee.

Increased bruising is especially common on the hands, arms, face, and legs.

2. Medications and Supplements

Certain medications and supplements can also make people more prone to bruising. According to the Mayo Clinic, these include:

  • aspirin
  • naproxen sodium
  • ibuprofen
  • Anticoagulants (blood thinners) such as warfarin and heparin
  • antiplatelet agent
  • some antibiotics and antidepressants

Dr. Allison-Ottey noted that fish oil, ginkgo biloba and St. John’s wort are also common culprits.

Deficiencies of needed vitamins and minerals are more common in older adults, which can affect skin health.

“People who are malnourished and have an unbalanced diet are more likely to bruise,” says Dr. Allison-Otty.

Vitamin C deficiency in particular increases the risk of internal bleeding and impaired wound healing, according to the Merck Manual. It can also lead to depression and fatigue.

Dr. Allison-Ottey said older adults who smoke are more likely to bruise than nonsmokers.

Chemicals in tobacco can cause blood vessels to become unstable, according to January 2019 findingsThrombosis and hemostasis.​This makes the blood vessels more likely to rupture and bleed from minor injuries.

According to the U.S. National Library of Medicine, up to 30 percent of adults 75 and older have actinic purpura, or solar purpura. This common skin condition occurs when prolonged exposure to UV rays can cause damage to the skin’s connective tissue, making it more prone to bruising.

Actinic purpura is harmless, but it can cause mottled purple spots on a person’s skin, especially on the backs of the hands, neck, face, or forearms, the U.S. National Library of Medicine states.

How to Prevent Bruises in Seniors

There are two important parts to reducing the risk of bruising as you age. The first is to find a way to avoid injury in the first place. The second is about taking steps to support the health of your skin and blood vessels, so if you get injured, bruises are less likely to form.

Dr. Allison-Ottey noted that older adults are more likely to trip and fall, which can lead to bruising. You can prevent falls by:

  • Stand up slowly so you don’t get dizzy
  • Check with your healthcare provider for medications that may cause dizziness or drowsiness and adjust as needed
  • According to the National Institute on Aging (NIA), wear sturdy shoes that support your feet and provide proper grip—non-slip, rubber-soled, low-heeled shoes are the best option
  • Use assistive devices such as a cane or walker if you feel unsteady

2. Keep your home environment safe

Hazards around the living space can cause you to trip or fall.

“Avoid cluttered and sharp-edged furniture, which can cause bumps and bruises,” advises Dr. Allison-Ottey.

According to the Centers for Disease Control and Prevention (CDC), you can also install grab bars in your bathroom and make sure you have grab bars and lights on every staircase.

3. Be proactive and prioritize balance exercises

The CDC states that regular physical activity can make you stronger, especially balance exercises that can help stabilize your feet.

Aim to get at least 150 minutes of moderate exercise (such as walking or swimming) per week and get into the habit of doing balance exercises.

Dr. Allison-Ottey notes that wearing an SPF 30 or higher every day and practicing sensible sun protection habits can protect your skin from further UV damage.

Eating a well-rounded diet, especially fruits and vegetables rich in vitamin C, can help your skin and blood vessels function optimally.

When to worry about bruises in older adults

Minor bruises are usually not a cause for concern if you know how the bruise happened (such as when you fell or bumped into something). However, if you’re bruising for no reason, or you find yourself starting to bruise more easily, you should talk to your doctor, advises Dr. Allison-Ottey. These can be signs of blood disease or certain cancers.

In rare cases, unexplained bruising can be a sign of elder abuse, especially if it coincides with other unexplained injuries or sudden changes in behavior, the NIA said. Get help if you suspect an older person is the victim of elder abuse. You can find where and how to report elder abuse at ncea.acl.gov.

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