Randy Jacobs, M.D. Patient Education

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Fragile Skin Bruising




What causes fragile skin bruising?


Easy bruising and bleeding into the skin of the tops of the hands and forearms occurs in many middle-aged and older people, especially if their skin is fair. This easy bleeding which can occur without apparent injury is a result of the skin's being made thin and fragile by years of sunlight exposure. It is not the result of a blood disorder or internal disease. The fact that bleeding occurs only on the sun-damaged areas of the hands and forearms, and never on the covered parts of the body, clearly shows that it results from local skin damage. If you see fragile skin bruising on non-sun exposed areas, there may be another cause for this. Please note that medications like prednisone, aspirin, ibuprofen, and coumadin can add significantly to fragile skin bruising. Sun exposure over the years, even without sunburning, has thinned your skin and damaged its support your skin and its blood vessels. Even slight movement may cause an unsupported blood vessel to break. This releases blood into the skin and leaves unsightly purplish marks.


How Does the Sun Cause Skin Damage?

Over time, the sun invisibly penetrates your skin and causes damage to the microscopic skin cells. The fibroblast cells (the cells that produce collagen and elastic skin tissue) are damaged. This causes collagen damage and elastic tissue damage and results in wrinkles and fragile skin on sun exposed areas. The basal and squamous cells are also damaged. This causes precancer and skin cancer. The melanocytes (pigment cells) are damaged. This causes melanoma and problems with your skin’s pigmentation.



Fragile skin bruising is a harmless nuisance. The skin damage produced by sunlight is permanent and treatment is not 100% effective . You can prevent further sun damage by using the sun-protective measures described by Dr. Jacobs. You can also help by keeping your skin well moisturized, and by applying over the counter Vitamin K cream to the areas twice a day. Ask your pharmacist for Vitamin K Cream. Aged skin shows depletion of necessary skin barrier cholesterol leading to dryness, scaling, and decreased skin barrier function.