Some time ago while seeing a 93-year-old patient, a lady who was definitely smart for her age, told me that I always looked young to her. To this statement, which arose from the fact that it had been a few years since we had seen each other, I had to reply that she saw me as young, but the difference between my age and hers had remained the same.
We actually see people from our perspective, and as we advance in years, others look younger to us. We see them as young. In fact, however, age advances for everyone and brings changes.
Skin, for example, changes as we get older: wrinkles, some spotting… One thing we don’t think about is that our skin becomes “thinner” over time: collagen is reduced and capillaries, which are already more fragile in themselves, are more exposed and break more easily. This generates small hematomas that are more common in areas exposed to trauma or rubbing, usually the extensor surface of the hands and forearms and the front region of the legs. Just like hematomas they then take on a brownish discoloration that tends to disappear over time.
It should be added,moreover, that in patients who have been taking cortisone for a long time this tendency develops earlier and more easily because of the hormone’s actions on the skin. Others, on the other hand, who use antiplatelet agents –the usual aspirin or clopidogrel to understand each other–or even more so anticoagulants, more easily present these phenomena because of the action of the drugs on coagulation. Today, it is true, we give antiplatelets more hardly in what is called primary prevention-that is, when nothing has happened yet-but still quite a number of the elderly take them.
Sometimes these manifestations are called Bateman’s purpura by the physician who first described it in the 1800s, other times senile purpura or dermatoporosis, but it is always the same thing. Should we be worried? Not for once . Can we or should we do anything about it? Should we not: it may be aesthetically unpleasant, but it does not in itself lead to illness or bleeding. If those close to us are concerned, we can reassure them. It is a normal consequence of the passage of time, sometimes accentuated by the medications we take.
If, on the other hand, the problem is that we find it unattractive, perhaps because we think it ages us before its time, little we can do, but a few things we can: keep the skin hydrated-sometimes a little cream is enough- drink enough, avoid trauma as much as possible, and don’t overdo sun exposure.
A little more can be done with nutrition, at least to reduce collagen loss: we need to take in vitamin C-an orange or kiwi a day would be enough-and lysine-rich foods, fish first, meat especially beef and pork, nuts, and finally vegetables. So in simple terms: a varied diet.
Of course, if these small “hematomas” increase too much or especially if they appear when we are still young, we need to hear the doctor’s advice, which we also need to do whenever we are in doubt, for example, because too many appear at the same time. This is even more valid for patients taking coumadin in whom a check of the INR-the self-monitoring of coagulation-would be necessary anyway.
C.I.D. s.r.l. Società a Socio Unico – Casa editrice del settimanale Gente Veneta – CF e PI 02341300271 – REA: VE – 211669 – Capitale Sociale 31.000 euro i.v. – Dorsoduro,1 – 30123 Venezia
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