A Dermatologists Guide To Purpura


Purpura is caused by bleeding underneath the skin. It presents as purple or red irregularly shaped discolorations that do not fade away when you apply pressure.  It most commonly occurs in areas prone to trauma, such as the forearms or shins. 

What Causes Purpura?

Although there are numerous potential causes of purpura, the most common type is called senile or actinic purpura and is due to changes in the skin secondary to aging and UV damage. As we age the tissues in our skin become thinner and the blood vessels in our skin become more fragile. Normally tissues in our skin act like pillows and support blood vessels, protecting them from trauma. When these tissues thin you lose the support surrounding the blood vessels so that even very minor trauma, such as lightly hitting your arm, can disrupt the blood vessel integrity and cause bleeding into the skin.

Who Gets It?

Senile purpura is very common and affects approximately 10% of people over the age of 50. Risk factors include chronic sun damage and fair complexion. People on blood thinners or aspirin are also more prone to developing it.

When To Worry?

Although senile purpura is completely benign, if you notice that you are developing large areas of involvement, have numerous lesions developing all at once, or a sudden development of lesions that you never had before, it might be a sign of an underlying medical problem.

Treatment Options For Purpura?

No treatment is necessary for actinic or senile purpura as the lesions are benign and will fade away on their own much like a bruise does. Unfortunately, due to the changes in the skin structure described above, new lesions will continue to appear. Sun protection and moisturizing the skin may help to prevent further damage to skin tissues and lead to less purpura in the future. Topical retinoids have been reported to decrease signs of aging on the skin and may also prevent senile purpura. Some studies have reported that oral supplementation of citrus bioflavonoids may help prevent its development due to their antioxidant effects. Studies have also shown that vitamin C supplementation improved purpura in patients who had a prior vitamin C deficiency.

If you have purpura and are bothered by the appearance of them there are a few things that may help the lesions fade more quickly. Arnica montana is an herbal remedy that can be applied topically to lesions to help them fade faster due to anti-inflammatory effects on the skin. Lasers may also be used to treat lesions and help them fade away faster.

Purpura is often frustrating and often cosmetically bothersome, but luckily it is usually not worrisome to your health. Please schedule a skin check with one of our board-certified dermatologists at Siperstein Dermatology Group to learn more or have your skin evaluated. 

If you’d like solutions for forearm bruising, please give us a call or make an appointment today!