Hematomas—those distinctive purple marks from burst blood vessels—appear more frequently in older adults. While often triggered by bumps or falls, which are common in seniors, they can also arise spontaneously. Age-related fragility in blood vessels and skin plays a key role, alongside certain diseases and medications that heighten the risk.
A hematoma, also known as a bruise or ecchymosis, is an accumulation of blood in tissues from ruptured vessels—a type of internal hemorrhage. They most commonly form under the skin (subcutaneous hematomas), appearing as swollen, dark blue lumps deeper than simple bruises. Bruises involve smaller vessels and show milder symptoms.
Hematomas typically cause little pain unless pressed but can make the affected area tender, especially if large. In older adults, whose overall health may decline, they can be more painful and take weeks to resolve—longer than the usual 10 days.
As the blood's hemoglobin breaks down, the color shifts from blue to green, ocher, and yellow before fading. Hematomas resolve slower than bruises, particularly in seniors.
Most hematomas follow significant trauma like falls or impacts, risks that rise with age. However, they can emerge without injury due to various underlying factors.
With age, blood vessels weaken and skin thins as cell renewal slows, delaying healing. This leads to spontaneous hematomas. Deficiencies in vitamins C and D, prevalent in older adults, exacerbate this vulnerability.
Women, with naturally thinner skin, and those with lifelong sun exposure also face higher risks.
Age-related conditions often reduce platelet counts, impairing clotting and promoting hematomas. Examples include hemophilia, leukemia, infections, and liver failure—more common in seniors.
Anticoagulants and antiplatelet drugs, prescribed to prevent cardiovascular issues (which rise with age), delay clotting and cause spontaneous hematomas. Corticosteroids, aspirin, certain antidepressants, asthma meds, long-term cortisone, and chemotherapy also heighten susceptibility.
