Easy Bruising - I notice a bruise (especially in skin in folks 50+), but I don't remember injuring my skin. At first it seems trivial, but over time, bruising occurs more frequently and lasts from days to weeks. After a while, the bruising doesn't seem to go away. In the areas where I bruise frequently, there is now always a flat brown ugly stain. Now I feel disfigured, and it reminds me of my folks when they got old. But I say to myself that I am NOT old, and do NOT feel old, but I look it.
The next phases are not pretty. Alongside bruising, I notice that my skin tears or breaks easily. Small tears become big open areas (the skin is literally torn apart), but I don't recall really injuring it. At this point we notice that it is hard to heal. I can stop the bleeding with simply pressure, but if I try to use tape to bring the skin back together, I get more tearing when I remove the tape. The skin itself is noticeably thin and looks like I can see through it. I notice I am developing what looks like little scars where I bruise. Some scars are shaped like stars, some straight lines, some just flat white areas. Uncommonly, the easy bruising causes serious bleeding and can occasionally require surgery.
How common is sun induced thinning?- Skin begins to thin in your 50's and becomes more apparent as we age. The best statistics say it affects 35% of folks over 65. It also runs in families. It is most common in sun exposed areas such as hands, forearms, face, neck, décolleté, and front of shins.
WHY does this happen? - What holds skin together (meaty layer/collagen) is a combination of collagen fibres, elastic tissue, and hyaluronic acid. Age and particularly if it's combined with chronic sun exposure (ie. gardeners, sailors, golfers, kayakers...etc) gradually destroys the collagen fibres (think of a collagen a a thin strand-like thread - we have millions of these) resulting in thinning and loss of strength of skin.
How does the sun make my skin thinner? - The effect of the energy of sun on skin is to create a chemical reaction that results in the release of free radicals (molecular sharks) that eat everything wherever they are created. So, every time I am in the sun, I chew up a bit more of the fibres, creating tiny breaks in the long strands. Over the course of years, the damage chews the strands of collagen from long strands to shorter pieces. When enough damage occurs, your body destroys the damaged fibres.
Can I fix it? - Nature provides her own little miracles. ;) Remember we talked about free radicles? What neutralizes free radicles are ANTIOXIDANTS. Fortunately, these naturally occur in skin. We are also able to add to our natural defences by applying antioxidants, which are simply VITAMINS (vital structures).
Vitamin A - The energy of the sun consumes our skin's naturally occurring Vitamin A. Scientists say that in 2 hours of sun exposure, we reduce our Vitamin A levels by 50%. This is an alarming amount, and is actually a vitamin deficiency. So, what happens if we restore the Vitamin A? Firstly, we increase protection from the sun. One of the Skin's Vitamin A(s) is retinyl palmitate, which naturally occurs in high concentrations in the epidermis. We can it Nature's Sunscreen, as retinyl palmitate (RP) has an SPF rating of 20. As long as it lasts, it is protective. The miracle of this Vitamin is that it also simulates the production of anchoring fibrils (the little stitches that hold the epidermis to the dermis), therefore minimizing bruising.
Side effects of Vitamin A = reversal of aging (not bad hey?) - Retinyl Palmitate very rapidly smooths skin, and over months, you'll see a reduction in the pigmented patches of aged skin. Repairing easy bruising is a slow process. In general, after a month of daily treatment, you'll notice that bruising begins healing more rapidly. After 3 months, skin becomes more resistant to tearing and bruising. The major effects and long term stabilizing will occur after applying Vitamin A daily for 1 year. You need to continue to use it, as damaging free radicles are created each time we are in the sun. Therefore, we must constantly repair and replace the Vitamin A that gets used up.
The other RECENT and "hot" treatment is Hyaluronic Acid. Remember how we talked earlier about the components of the Dermis? The stuff between our collagen is Hyaluronic Acid. It is the part that holds water (1000 times its weight). Most treatments of HA are ineffective as the molecules of Hyaluronic Acid are to large to penetrate skin. Science has taught us that if we use creams composed of ONLY the smallest molecules, then they can penetrate and be effective. Check your cream labels! Look for 50 KDA - that means the molecules are small enough to be absorbed.
What does treatment look like? - The most effective treatment has proven to be retinyl palmitate (1.5% or retinol or 0.5% combined with low molecular weight HA). If there are 2 Topical Vitamin creams (1 Vitamin A, 1 with HA), one would be applied in the morning, and the other one at night. We suggest treating the face including eyelids, lips, ears, décolleté, and back of the hands up to the shoulders - all sun exposed areas. Creams applied to wet skin are easy to spread and help you to save money. ;)
Are there other Vitamins that help? - Vitamin C is always great. Like Vitamin A, it is an antioxidant. It directly neutralizes free radicles, and stimulates production of collagen type 2 and 4 - thick collagen. Vitamin E is also an antioxidant, and helps protect the membrane structure of the cell.
Are there other causes of easy bruising? - Dermatologist recognize that Topical cortisone can contribute to the thinning of skin. The stronger the steroid, the more rapidly the appearance. A potent steroid should not be used for more than 3 months if its being used daily.
Oral Prednisone - causes problems all through skin.
Folks on Anticoagulants (ASA, heparin, warfarin, and new anti-platelet agents) all notice increased bruising and skin thinning appearance.
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