Robert A. Hayden, DC, PhD, FICC
Have you noticed your skin bruising easily, or even tearing like tissue paper? This is certainly an aesthetic issue, but it may also be frightening. We need to understand what is happening to our skin as it ages to better care for ourselves.
Our skin is our largest and most obvious organ. It is exposed to the environment every day with ultraviolet light, abrasion, sharp objects, biohazards, and the drying effect of wind. It has a marvelous ability to heal and repair itself throughout our lives.
Underneath our skin is a layer of fat tissue. Fat does a number of things for us. It stores energy. It acts as connective tissue that anchors your skin to the subcutaneous layers below. It insulates the body from radical changes in temperature in the environment. It gives shape to our bodies that is genetically determined and heavily influenced by hormones. It even acts as a cushion when you fall or bump a piece of furniture.
As we “mature,” this fat layer gets thinner and may virtually disappear. This results in the skin even looking almost transparent sometimes and losing its resilience and resistance to stretching. It gets fragile and subject to tearing with shearing force. It will bruise easily because the loss of the fat layer exposes blood vessels to stretching and tearing as well. The slightest incidental trauma may produce many shades of red, blue, and purple under the skin. Many of my senior patients react in horror as they walk across the room and brush of forearm accidentally against a door facing or the edge of a sofa. Senior skin tears like wet toilet tissue in a jagged, frightening wound.
Of course, these bruises and tears are even more dramatic among those of us who take blood thinning drugs. Aspirin, Plavix, Coumadin, and other drugs will prevent blood from clotting as quickly as it would normally, so bruising is worse and bleeding is more profuse under the circumstances.
Actually, most of these tears in the skin heal quite well and surprisingly quickly. We treat them in the clinic by cleaning the surrounding skin with Betadine and approximating the edges of the tear, securing with Steri-Strips, a special kind of sterile tape used to close lacerations. We will use a topical antibiotic and sterile gauze, wrapping the entire wound with a stretchy material so that we do not have to use any tape. We apply an ice pack for about 20 minutes to stop bleeding. Sometimes we will accelerate the healing with laser treatments, but most often these tears will heal with remarkable speed.
How can we prevent these unsightly and unnerving traumas? There are some good strategies we can use.
When you know you are going to be outside working in the yard, roughhousing with grandchildren, playing with your dog, or doing anything else that might predispose you to incidental trauma, wear long sleeves. It is hot outside right now, but these sleeves do not have to be thick material. Any sleeve will help to reduce abrasion on your skin.
Avoid extended sun exposure. When I was just a boy, and I now define that as less than 50 years of age, I was out in the sun getting a tan whenever possible. Now I am paying for that as I go to my dermatologist every couple of years to have something cut off and sent to a lab for analysis. The lack of fat layer under your skin removes a degree of protection not only from damaging rays of the sun, but from the heat in the infrared rays of the sun because you have lost a significant amount of insulation. When you are in the sun, use a good sun blocker often, particularly if you are sweating or in a swimming pool. Watch the time – when you are having fun, the time can get away from you and you may find you were in the sun longer than you planned.
Keep your skin moisturized. There are some good external moisturizers you can use, but also pay attention to the nutritional aspect of your skin. Make sure you are getting plenty of vitamin A and vitamin D. I highly recommend a good omega-3 that you can get from eating fish or from omega-3 supplementation. It contains essential nutrients for your skin, and it will keep your cholesterol down as well.
Inspect your skin on a regular basis. Report moles that looks suspicious or that have changed in color, size, or texture to your Doctor at next visit.
Your skin is designed to last you for a lifetime. Get comfortable in it and give it some good care.