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Why skin on the back of your arms and hands bruises and tears easily and what you can do about itHow to Get Rid of Bruising and Thin Skin on the Arms and Hands

 

There are questions related to common dermatology conditions that come up repeatedly. They are not the main reason for a dermatology clinic appointment and patients usually consider them too minor to mention until I am walking out of the room.

One of the more common problems is:

Why does the skin on my arms and hands tear and bruise so easily?

This common problem usually occurs on the backs of the forearms and hands, as we get older. It occurs due to a combination of chronic sun exposure, thinning of the skin with aging. It is worse in patients on chronic corticosteroids, prescription blood thinners, OTC aspirin, or NSAID’s (Advil, Aleve etc.).

The skin on the forearms and back of the hands gets sun exposure daily over many years. People who work or recreate outside often do so in short sleeves and without gloves. Many people rarely apply sunscreen to those areas. Moreover, of course, many people who are now experiencing the effects of chronic sun exposure over many years received their exposure long before good sunscreens were available and before the harmful effects were widely known, and long before they had enough sense to protect their skin.

Ultraviolet radiation over years damages the collagen and elastic fiber framework diffusely throughout the skin and in the supporting structure surrounding the blood vessels in the skin. Unfortunately, skin naturally thins with aging. Prescription or OTC medications increase bleeding tendencies. Chronic corticosteroid medications make skin more fragile. Combined together, these problems cause the skin to tear and bruise easily. In patients who are not on chronic corticosteroids, the most severely affected areas are the sun-exposed backs of forearms and hands. One of the easiest ways to see the effects of long-term sun exposure is to look at the back of your forearm, then turn it over and compare it to the sun protected inside.

The next question is then – “very interesting but what do I do now?”

How can I get rid of the bruises and thin skin on my arms and hands?

The best approach by far is prevention, which includes sun protection with either clothing or sunscreen every single day starting as early in life as possible. Like much of the damaging results from chronic sun exposure, the easy bruising and skin fragility occur many years later. While you are at it, don’t forget to protect your neck and the V of your chest. You will be thankful you did later.

To try to thicken then skin, reduce wrinkling and spots too, anti-aging creams and lotions that increase collagen production help to some degree if used over a long time. Thicker skin with more collagen doesn’t tear as easily, and increasing collagen around the fragile blood vessels makes them more resistant to bruising.

Like most of our anti-aging skin strategies, it is definitely best to start early to prevent damage. But even after the damage is done, it is never too late to get some improvement  The most effective, but more costly, strategy  is to use the same anti-aging skin care products you use on your face on your arms and backs of hands. Anti-aging skin care products designed for the face usually have higher concentrations of the active ingredients than those designed for the body. This is due to the cost of the ingredients for the surface area covered, and customer’s willingness to spend more money on their face than their body.

Ingredients that increase collagen:

  • Prescription retinoid (Retin A, Renova, Refissa, Differin, Tazorac)
  • Non-prescription retinol
  • Alpha hydroxyacids (Glycolic Acid, Multi-Fruit Acid)
  • Peptides
  • Growth Factors

What about vitamin K creams for bruising on the back of arms and hands?

There are quite a few vitamin K creams promoted to improve the bruising, but not the thinning skin, on the back of the arms and hands. Vitamin K, also known as phytonadione, is a cofactor in the biosynthesis of clotting factors II (prothrombin), VII, IX, and X. There have been few studies on the usefulness of vitamin K creams in the treatment of chronic purpura (bruising). Most of the few studies done have investigated it for treating laser-induced bruising and those few studies have had varying outcomes. For this reason, it needs more study before I would recommend it.

Are there any other treatment options?

Very dilute injections of Sculptra can increase collagen production in some patients.

Do creams really work to improve bruising and thin skin on the back of the arms and hands? Is it worth the money?

My opinion is that it is definitely worth it to use the creams as a preventative anti-aging, anti-thin skin, and anti-bruising strategy and start very early. Once the problem occurs, the correct decision is not so clear. As treatment, to reverse the problem, the improvement after long-term use is somewhere between worst-case none to best-case modest. There is a cost involved and a relatively large surface area to cover. Some of the creams, especially the prescription retinoids, can cause skin irritation and rashes on the thin skin of the arms and hands. You have to do your own cost-benefit-hassle analysis.

Without doubt, the single most clinically effective and cost-effective thing you can do is sun protection as a preventative strategy. Prevention is much easier, and much more effective than treatment after the problem occurs. Dare I say—an ounce of prevention is worth a pound of cure. Seems a lot of life is like that.

38 comments

Posted on June 06, 2016 by Jackie Freer

This was very depressing for someone with the condition already. How do you remedy it?

Posted on June 06, 2016 by Billy Luther

Same here Jackie….it really sucks

Posted on July 07, 2016 by Peter Willain

Can any good creams be got on prescription from GP?

Posted on July 07, 2016 by Kathy Dowdy

There are thousands of creams to soften skin is there not ONE to toughen skin?????

Posted on August 08, 2016 by Annette

Even if I wear a watch it makes the red marks and it just looks terrible…ugh!  The price of getting old…but I guess it beats the alternative….good luck everyone…

Posted on August 08, 2016 by Darlene

After spending years getting that ” healthy look ” there’s another reason not to spend time in the sun. Not just wrinkles but think skin too!

Posted on August 08, 2016 by K.ball@telus.net

Now I no the cause for thining skin what can I do to slow it or stop it on the forearms .

Posted on January 01, 2017 by Carolyn Mathieu

What should be used on arms, once it shows up it takes 3 weeks for it to go away.
HELP!!!!!!!!!!!

Posted on January 01, 2017 by Donna Andrus

Ppl look at me like I’m contagious. I can’t help I’m old….how can I get ppl to know I’ve just have thin skin….

Posted on February 02, 2017 by Dorothy

I am 65 years old, was told sun exposure caused my “thin” skin.  The slightest bump or even scratching causes HUGE purple spots on my arms, ONLY on my ars.  Is tree any relief or help in sight?

Posted on February 02, 2017 by Dr. Elaine Cook M.D.

Hi All,

Yes, it is very frustrating. As I stated in the blog post, an ounce of prevention is worth a pound of cure. Sun Protection starting in your teens!

For those of us who can’t go back and re-do our teens and young aduthood—which is all of us, options aren’t great, but we can do what we can, with what we have.

1) Retinoids—the best are prescription Retin-A either plain Retin-A (tretinoin) or the emollient cream Refissa, which can, over time, help build the new collagen to support the skin and blood vessels in the skin. That requires a prescription, and can be drying and irritating. But manageable, and worth doing. Takes many months - years to see results.

2) OTC retinoids, either alone or in combination with peptides to help build up the collagen. Not as effective as prescription retinoids, but has the advantage of not requiring a prescription, and the skin tolerates it better. Try our Line Diminisher (https://skintreatment.com/line-diminisher) which has 2% bio-available retinol, peptides and botanicals like green tea to help you tolerate it better. There are also a lot of other OTC retinol products you can buy without a prescription to treat the problem. Takes many months - years to see results.

3) Peptides and active Vitamin C also helps build collagen, but again,  takes months-years to see results.

4) Injections of Sculptra, in dilute amounts, helps you build your own collagen. See your Board Certified Dermatologist for advice. Great option, but be sure to see a qualified dermatologist, as there are risks of nodules, and you want the best results.

5) IPL or IPL/PDT helps reduce the abnormal blood vessels. See your Board Certified Dermatologist for advice. Often combined with a retinoid and Sculptra treatment.

6) Really, really, really try to prevent trauma to the forearms and back of the hands. Gloves, long sleeves etc. Tell those puppies and kittens to chill out.

7) When you get those rips and tears to the skin, wash them gently with plain soap and water, smooth them back down flat with the skin. Make sure the edge is not balled up, they need to be perfectly flat. Apply an occlusive type bandage dressing such as Band-aid Advanced Healing and leave it on for a week or so until the rip is healed. I am always amazed at how easily these rips heal, and how good they look afterwards, if completely flattened out and kept perfectly flat.

8) There is not a great answer, with what we have available currently. Do the best you can, with what you have. Persevere.

Posted on February 02, 2017 by Janet

Due to medication, my skin got thin and tear easily.
I use to just patch the skin back on my arm (less painful)
It covered and healed quickly but,
Now that skin is dark with white patchec where the skin came off completly.
My arms look terrible and very embarresing! Everybody wants to know what is wring.
Did you got burned etc?
What and how can I get rid of that top layer of skin that seems lose on my arm?

Posted on February 02, 2017 by Mary

I live on Cover Girl cover up sticks and Sally Hansen tanning lotion for legs, on my arms!

Posted on March 03, 2017 by Dorothy Day

I found that if I use a heavy cream with retinal and cover with a thin coat of Vaseline my skin appeared to feel stronger on my arms it took a few weeks of twice a day but better than spending money I couldn’t afford

Posted on March 03, 2017 by Michelle

It is so frustrating I am only 51 and my arms look like I’m in my 70s or 80s I’m told it’s from the medications that I take.  My friends make comments about my arms and people I don’t know ask me about why my arms look so bad at my age it’s very embarrassing I wish I knew how to keep my skin from tearing and bruising and it is not because I am out in the sun

Posted on March 03, 2017 by Ruth

Well i am 58 ,and it finely has happen what a bummer the blood blisters on my arm from working out in the yard with short sleeves oh well lesson learned. Even though you feel 25 in your heart your body is blowing your cover !!!

Posted on March 03, 2017 by Sally Schleiger

This is a great article, with helpful tips that work (socks)
https://www.caring.com/questions/thin-skin

Posted on March 03, 2017 by zoe brown

no help at all just want to know how to help my skin now

Posted on April 04, 2017 by elisa stancil

I read through all the comments and also the posts from the doc.  I started having this skin thinning and bruising at 42 right after a hysterectomy.  I had exposure to chemicals through my work and also lots of sun exposure.  Now I am 67 and the fragility is extreme.  I tried retin-a but was not consistent with it.  I am going to try Refissa, just happen to be seeing my dermatologist tomorrow.  He is board certified and I trust him so will inquire about scupltra…But keep in mind, some meds, like thyroid, thin the skin and some genetic factors seem to matter too, my father has the same skin, very freckly and lots of sun damage and skin cancer.  I do find that the areas where there is scar tissue is much stronger than the other areas….I decided that was a benefit, though there is a color difference since the scars are white. 

Posted on April 04, 2017 by judy

my arms are thin skin/saggy skin wrinkled both back and front. I’m 68.  It’s probably on my legs to, but i don’t see them. I see my arms all the time and it really bothers me, i play guitar a lot. That’s when i first noticed it. It happened suddenly. i was lucky to be aging very gradually, until i had a benign tumor of the pancreas called insulinoma ,which i had for many years without knowing, the symptoms were subtle, and seemed like something “just psychological.” in retrospect, blood tests show that i first started having abnormally low glucose, 30s, 50s, in 2006. That was when the subtle symptoms started, unable to handle stress at my stressful job, whereas previously i handled it fine. i thought i was wearing out. Finally i was forced to retire early, age 63, because my judgement at work was so bad. After a year, i started having more dramatic symptoms that couldn’t just be caused by “mental problems.” i fell, i got up and fell again. I had no coordination, i couldn’t get a measuring cup under the faucet to get some water to boil. When i ate a very small amount, even a bite, the symptoms went away, so i started looking into hypoglycemia, the second episode i had, i woke up in the morning falling out of bed. i had urine on my nightgown but didn’t remember. i couldn’t get up because i had no coordination. i knew i needed to eat something, i drug myself to the kitchen, low to the floor because i would crash into he walls, one bite of play rye bread and the symptoms went away. went to an endocrinologist. By then i was testing my glucose wit a home tester several times a day, glucose extremely low. This tumor is so rare, the endocrinoligist said it wasn’t an endocrinological problem, he sent me to a gastroenterologist. That guy was smart and said “I think it’s strange no one tested your insulin to rule out insulinoma.”  He tested it and it showed i had insulinoma tumor.  By that time , i knew i had eat more. The only treat meant for the tumor is surgery which i began setting up and it took about 3 months, and in the mean time the only thing i could do for it was to eat more. It killed me to do that, i knew i would put weight on and i was 65, weight had been stable at 134 for along time. but i knew at my age, the last thing i wanted to do was to stretch my skin out and then lose the weight after the surgery when i could eat normal again(the hypoglycemia was caused by fasting so i was supposed to eat around the clock). My weight went up fast, steadily, and i backed off on after gaining 10 pounds, and i immediately had seizures, i don’t know for sure because i live alone, but i woke laying on the floor, no memory of how i got there, urine on nightgown, unable to enunciate words, unable to get up, unable to move, i could move but not for any purpose. It wore off after about 10 minutes. It happened two days in a row, and then my rebellious nature gave in and went back to eating more. By the time of the surgery, i had gained 15 pounds and weighed more than i had weighed since i was pregnant, 30 years before. After the surgery, i easily lost the weight, i iost 20 pounds. i expected my face to sag, after looking pretty young for my age abefore, but i didn’t knotice much change.  about a year and a half after the surgery and weight changes, i was playing guitar one day and i saw my arm ad i thought, oh my god!!  that’s not my arm.  It was so different, it looked like the arm of someone well into their 80s, and i was 67. It was most noticeable on the skin on the underside of my forearms. It’s bee like that for months now and it really bothers me, my arms look so old and not like the rest of me, i knew my skin was going to stretch out and not go back at my age if i gained weuight but i only thought it would be my face, and if it was too bad, i could get a face lift. But there’s nothing surgical that can be done for my arms with the stretched out thin very wrinkled skin. Also part of the problem is a rash all over my arms and other places on my body, which causes me to wonder whether my skin could tolerate retinol. It’s a rash that doesn’t hurt or itch, but it’s extensive, not symmetrcal, i’ve been examined and biopsied by a dermatologist steroids were recommended, i declined, the area is too extensive the doctor wanted me to take oral steroids temporarily, but i don’t think my immune system needs that, and i think it would just com back when i stop the steroids. I went to an allergist and he tested for everything and i am allergic to nothing, which didn’t surprise me.  So, that is a dead end, i ‘m stuck with the rash.  i think it’s contributing to the thinking skin.  I don’t want to see what my arms look like but summer is coming and it will be too hot to wear long sleeves.  i’m sad about it.

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