Is there such a thing as "thin skin"?

Jas asked...

My 87 year-old mother lives with us and has moderate dementia. My question is about her thin skin and her tendency to bleed easily. She has dark spots which she calls bruises but actually appear to be blood pooled under the skin making dark red or purplish blotches. They appear on her lower arms and she doesn't get rid of one before another one appears. Her Dr. has told me that it is a result of her thin skin at her age. It doesn't seem to take much for the surface of the thin skin to break and for her to bleed, sometimes just mildly bumping furniture will do it, as well as when her dog gets playful it can happen. I am at a loss to prevent this as her arms look awful most of the time. I have never seen her actually cause one of these blotches but she always says she bumped into something or the dog "scratched" her. Both situations that would not normally cause this type of injury. She is very self-conscious about it and with the dementia issue, if she were questioned by someone, I'm not sure if she could give a reasonable explanation. I have trouble figuring it out myself. In your opinion, would this be due to "thin skin"? Thank you.

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

As people grow older, their skin tends to become more fragile, and they lose the nice layer of fat that lies right under the skin, which used to protect them from bumps and bruises.  Regarding your mother's skin issue, it is very common for this bruising to happen as people age.  The "splotches" you speak of can be worse if someone is on a blood thinner (like Aspirin, Coumadin. or Plavix), which are commonly used to prevent strokes and heart attacks in older folks.  Another medication that can do this is Prednisone, which can make the skin thin and cause bruising too.  You can check with her health care provider to make sure if she is taking any of these medications that they are really necessary, especially if the bruising gets severe.

All that aside, you would like to know how to protect her skin and prevent these bruises.  First, make sure her environment is uncluttered, as anything she bumps into will leave a mark (as you said).  Second, you can cover her arms / hands with thick, long white socks with the toes cut out (make them like a glove) so that she can wear these around the house to protect her skin.  These socks are effective, as they offer some additional cushioning, and they are washable and cheap.  Third, if she uses a wheelchair or furniture routinely, make sure that any sharp parts are covered to protect her skin. Lastly, about her dog- make sure the dogs nails are trimmed to keep her from getting scratched.