Dr. Rosanne Leipzig, Professor and Vice Chair of the Brookdale Department of Geriatrics and Adult Development at the Icahn School of Medicine at Mt. Sinai in New York, N.Y., addresses reader questions on bruising and pressure sores.
Q. I seem to bruise so easily these days—is there anything I can do to prevent it?
A. As you get older, your skin becomes thinner, and you lose some of the protective layer of fat underneath it. This means that if you bump your arm or leg against the furniture, you can easily break the blood vessels just under the surface of your skin and cause a bruise.
The problem may be worse if you take blood-thinning drugs, such as daily low-dose aspirin, clopidogrel (Plavix®), or warfarin (Coumadin®), since they affect blood clotting. Some supplements, including gingko, garlic, and fish oil can have a similar effect.
There isn’t much you can do to avoid bruises, aside from clearing your house of any clutter so that you don’t bump into anything, or fall. If you’re concerned about your appearance, you can cover bruises with make-up until they heal. Occasional bruising shouldn’t be cause for concern, but bruising that occurs without an obvious cause should be checked out by your doctor—particularly if you take blood thinning drugs.
Q. I developed a painful pressure sore while recovering from surgery in hospital a few years ago. I’m due to have surgery again soon—can you offer any tips for avoiding a recurrence?
A. Your pressure sore was likely caused by staying in one position for too long—this reduces the blood supply to the skin and underlying tissues, and if the blood supply isn’t restored, a sore may develop. Unfortunately, older adults are especially vulnerable to sores because their skin is thinner and can sustain damage even from fairly light pressure.
Sores are most likely to develop over bony areas of the body that have less fat to pad them—for example, the heels, hips, base of the spine, and shoulder blades—so try to avoid prolonged pressure on these areas. Use pillows or supportive foam wedges as extra padding, and place a pillow under your calves to raise your heels off the mattress. Change your resting position at least every two hours (ask for help to do so if necessary), and ensure that the bed sheets remain smooth under your body. Also check (or ask a nurse or relative to check) vulnerable areas each day for signs that a sore may be developing.
Rosanne Leipzig, MD, PhD, is Professor and Vice Chair of the Brookdale Department of Geriatrics and Adult Development at the Icahn School of Medicine at Mt. Sinai in New York, N.Y. She also serves as Editor-in-Chief of the monthly publication Mount Sinai School of Medicine Focus on Healthy Aging.