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Watch Out For That Marshmallow

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By PHILIP MORGAN | The Tampa Tribune

Published: February 15, 2008

It's fascinating to watch age transform me. Of course, that's a little like one of Custer's soldiers saying, "Wow! Check out those circling Sioux warriors!"

The skin, being our most voluminous organ, offers a showcase for the steady march toward eternity. We get the wrinkles, age warts, liver spots, the skin tags, the — hey, what are these purple blotches all over my forearm? They look like the splotches my late mother got in her 80s. I'm a mere pup of 60!

The condition is called actinic purpura. You discover that by searching "elderly," "blotches" and "forearms" on the Internet. It's the result of letting my forearms go naked for decades in the blistering Florida sun.

"What happens is, when your skin gets so damaged by the sun, the collagen and elastic fibers that give structure to the skin, they become changed," says Neal Alan Fenske, chairman of the dermatology department at USF Health. The tissue turns into "this amorphous, Jello-like matrix that the blood vessels now sit in."

Yuck.

The vessels have no support. To make it worse, age and sun damage enlarges and weakens them. The result? A gentle bump is all it takes to start a minor hemorrhage. And the telltale blotch remains for two to three weeks.

Some people get actinic purpura in their 50s; others get it in their 80s, Fenske says. It depends on the cumulative damage caused by ultraviolet radiation and the skin's susceptibility to it. Fair skin fares worse.

Medicines that thin blood or ease circulation — Coumadin, aspirin or ginkgo biloba, for example — aggravate the problem.

Young people looking to avoid actinic purpura can do several things.

"Of the 10 most important things to do," Fenske says, "the first nine would be to get out of the sun."

Short of that, wear protective clothing. And if you can't do that, wear a sun block that protects against both UVA and UVB radiation. A 15 SPF is sufficient if it offers such broad spectrum protection, he says.

That's good advice for people who already have the condition, too. "Repair is always ongoing," Fenske says. Plus, retinoid drugs can help rebuild collagen, though that's a long, slow process.

Meanwhile, I'll try not to slam my arm against marshmallows.

Reporter Philip Morgan can be reached at (813) 259-7609 or pmorgan@tampatrib.com.

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