Ask Dr. Gott » abnormal bruising

Bruising more common as we age

Dr. Gott — Thu, 18 Nov 2010 05:01:52 +0000

DEAR DR. GOTT: I enjoy your column. I’m a 68-year-old female in good health but recently developed unsightly red bruise marks on my arms and legs. These seem to occur without my even knowing that I have hit something. Sometimes the skin breaks, and it is hard to stop the bleeding. My dermatologist says the bruises are due to lost skin elasticity.

I grew up in an era when sunscreen was unknown. Do you know of anything that would help? The only thing the dermatologist recommended was to moisturize.

DEAR READER: You share a common problem with many other people. As we age, our skin becomes thinner and loses some of the fat that cushions our blood vessels against injury. While bruising can occur on any part of the body, the backs of hands seem extremely susceptible. This isn’t generally an indication of an underlying medical condition but is attributed to several conditions.

Years of excessive sun exposure, either today or in years past, can break down collagen and elastin fibers in the deep layers of our skin. Some medications, specifically anticoagulants (such as Coumadin and aspirin) or corticosteroids can weaken skin and blood vessels. Speak with your physician to determine whether any drugs you might be on have bruising as a known side effect. Finally, some medical conditions and/or bleeding disorders can result in spontaneous bruising called ecchymosis.

Your options are limited. Take precautions to prevent banging into things. Avoid direct sun exposure unless you are appropriately covered with sunblock. Wear long-sleeved shirts and long pants to cover your lesions until they clear. Do not shower or bathe in extremely hot water, as it will dry your skin out faster. Pat your skin dry following bathing rather than rub briskly with a towel. Keep your skin well moisturized with a topical cream or lotion containing petroleum jelly, lanolin, or vitamin E. Eat a well-balanced diet and exercise as much as possible.

Abnormal bruising needs testing

Dr. Gott — Tue, 28 Sep 2010 05:01:46 +0000

DEAR DR. GOTT: My mother is 63 and doesn’t take anticoagulants or OTC pain relievers but bruises for no apparent reason. An area of her body will begin to itch and then bruise. The bruise follows the normal course of color change and then disappears.

Her eye doctor saw “floaters” in her eye and sent her to a specialist because he thought she had a detached retina. After testing, it was discovered her “floaters” were flecks of blood.

She read in one of your previous columns that rutin could help with bruising. Since starting it, her eyes have improved, but bruises still appear on her body. Her physician does not take her seriously. Do you have idea or suggestions about what could be going on?

DEAR READER: Your mother needs to undergo thorough testing and examination. Is she on any over-the-counter medications, supplements or herbals other than the rutin? Does she have any other health concerns or conditions, such as high blood pressure or diabetes?

If her doctor is unwilling to look into this, it is time to find a new one. You might begin with a referral to a hematologist (blood specialist), who can test her for possible underlying causes, such as a clotting disorder.

To provide related information, I am sending you a copy of my Health Report “Blood — Donations and Disorders.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and sent to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Can aspirin cause bruising?

Dr. Gott — Thu, 24 Jun 2010 05:01:48 +0000

DEAR DR. GOTT: I am a 66-year-old female in good health. I have been on an 81 milligram aspirin a day for the last six years. I had a pacemaker inserted in 2007, owing to an electrical problem in my heart. Since then, I have had a problem I attribute to the aspirin, but I’m not sure that’s the culprit. I have blood that pools right under the skin on the lower part of my arms. The blood is very dark — almost black — and sometimes a bit raised. It takes from three to four weeks to fade away, and when it does fade, it leaves a brown spot where it was. I don’t have to hit or scrape my arm. The blood just appears. Right now, I have four large spots on my right arm near the wrist. They are most unsightly, and I have taken to covering them with Band-Aids, but then people ask me what happened to my arm. The only way to hide them would be to wear a long-sleeved blouse all the time. Since I live in Louisiana, where the summers are steamy, I just could not do that.

Is the aspirin causing this? My primary-care doctor said my skin is thin and there is nothing I can do about it. My skin doesn’t seem thin to me. This is upsetting, because I am never without one or more spot on my arms. The right arm seems to get more (I am right-handed), and it seems worse in the warmer months.

By the way, I take flecainide 50 milligrams twice a day, Tegretol XR 900 milligrams once a day (to prevent seizures due to a blow to my head last fall) and Premarin 0.625 milligrams. Can you please give me some help and hope?

DEAR READER: To begin with, your doctor is correct that your skin is thinner. This occurs because a portion of the protective fatty layer of skin that helps cushion blood vessels against injury is lost as we age. There is also the possibility that excess sun exposure over the years has broken down the collagen and elastin fibers in the deep layers of your skin. One more possibility is a side effect of medication you may be on, including the 81 milligrams daily aspirin that acts as an anticoagulant. I should indicate it is common for aspirin, even the 81-milligram strength, to be prescribed to people with abnormal cardiac conditions.

The Tegretol XR you are taking has uncommon side effects of severe allergic reactions, including unusual bruising or bleeding. I am not saying this is the cause of your bruising, but adding this to your aspirin regimen might be the cause. Speak with your physician or cardiologist for his or her interpretation.

Take extra precautions to avoid direct stress to your skin. Your physician(s) will likely continue you on your current medications because of your medical history. As such, you may find yourself wearing long-sleeved shirts when out in public.

To provide related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.