Senile purpura

Bruising that occurs in the elderly is known as senile purpura or purpura senilis.

The bruising beneath the skin occurs without any major external impact – for example, as a result of a gentle blow.

It is caused by changes in the skin: as the skin ages, particularly as a result of UV radiation, the skin tissue becomes thinner and less elastic. It cannot adequately protect the fragile blood vessels below. So they bleed easily and bruising occurs.

Senile purpura is painless and it clears up on its own.

It can recur, however. The changes can be mentally stressful.

The bruises are often violet and they can vary in size, with a diameter of between 1 and 4 centimeters.

They usually appear on the back of the hands or on the lower arm. However, they can affect other parts of the body, such as the legs, neck and face. The area of skin around the bruises is usually thin, dark-colored and inelastic.

The bruises do not cause any pain or itching. 

With senile purpura, bruising typically occurs even as a result of light bumps. The reason is that with age, particularly as a result of UV radiation, the skin tissue becomes thinner and less elastic.

The small blood vessels in the skin also become more fragile, so that they leak and bleed more easily. So bruises usually occur on parts of the body that are most exposed to the sun.

There are a number of factors that increase the probability that senile purpura will develop:

• frequent, lengthy sunbathing
• a pale skin type
• increasing age

The probability of getting senile purpura increases with age. It also often occurs if the skin has been exposed to a lot of sunlight throughout a person’s life.

Around 12 percent of people develop senile purpura after the age of 50, and up to 30 percent after the age of 75.

The bruises fade away after 1 to 3 weeks. Sometimes brownish patches of pigment remain. Senile purpura is without any complications. However, the bruises can keep reappearing and be a nuisance.

With senile purpura, bruising occurs with very little external impact – often just slight bumps. Being generally careful, and also during personal care, can prevent bruising from occurring.

Good sun protection, in particular, for example wearing long clothing, can prevent the skin from being aged by sunlight. Suncream with a high protection factor (SPF 50 plus) also protects the skin from UV-A and UV-B radiation which is one of the main causes of senile purpura.

A doctor usually diagnoses senile purpura through a physical examination of the areas affected and by asking about the patient’s case history. The latter will involve asking questions about the patient’s past illnesses. This can rule out other reasons behind the bruising.

Senile purpura is a harmless skin change that is not associated with any complications. The bruises do not cause any pain or itching, and they clear up by themselves. So there is no need for any specific treatment.

If the skin is very dry, a moisturizer can be applied.