Aging Skin

A common skin condition that worries many patients is called Bateman's Purpura, named after British dermatology pioneer, Thomas Bateman. I prefer this name to the more common name of Senile Purpura. It is also called Solar Purpura as it reflects long-term sun damage to the skin and vessels. I hate telling patients the red and purple splotches along their arms, hands and legs is called Senile Purpura so Bateman's Purpura it is! It only happens in aging skin, usually worsening after the age of 50.

Over time and with sun damage to the DNA, the blood vessels and collagen of the skin weaken. As subcutaneous fat is lost, the skin becomes thinner and less elastic and small areas of broken blood vessels bleed under the skin causing bruises and blotches. The fragile vessels bleed with very little pressure or trauma. Most of the time people don't even know they have slight trauma and they wake up with the purplish blotches.

Blood thinners, aspirin, alcohol and corticosteroids can also cause fragile vessels. Up to 30% of people over the age of 75 experience Bateman's Purpura and it affects both genders equally. These purple blotches fade away over time and cause no serious problems. Protection with sunscreens and moisturizers can help prevent further damage.

What does and doesn't work? Double blind studies using 0.1% Retinoic acid (Retin A) showed no effect compared with placebo. Application of Arnica gel showed improved wound healing in animals and may be effective in reducing, (but not preventing) the redness of Bateman's Purpura. Topical Niacinamide has shown improvement in fine lines, hyperpigmented spots and red blotches on the face, but hasn't been studied for Bateman's Purpura.

Vitamin C is required for the synthesis of collagen and one double-blind controlled study showed after two months of Vitamin C supplementation, there was reduction of purpura (red spots) and small capillary hemorrhages. A study showed 5% Vitamin C cream slightly improved elasticity and skin thickness in elderly patients and it is good for skin healing after trauma or laser treatments.

What about the current craze of collagen supplementation? Does that work? A new study looking at 56 women (ages 60-93) showed no benefits of oral or topical collagen for improving skin thickness or skin appearance compared to placebo. But both groups (collagen peptide and placebo) had better skin hydration, smoothness, reduction of wrinkles, hair and nail improvement and joint pain. It seems the placebo effect, along with good skin care, is the best treatment for aging skin.