Medical Care
Actinic purpura does not require extensive medical care. To prevent further ultraviolet-induced damage to the skin, sunscreens that provide both UV-A and UV-B protection should be applied daily, especially to areas affected by the purpuric lesions. Patients should also use barrier protection (eg, clothing). Inform patients that sunscreens help prevent but do not reverse the photodamage.
Tretinoin has been observed to reverse many changes that occur with photodamage. The use of tretinoin may be beneficial in actinic purpura because photodamage is ultimately responsible for this disorder. Tretinoin increases the amount of dermal collagen and decreases the amount of abnormal elastin when applied topically. However, to the authors' knowledge, no results demonstrate that actinic purpura lesions improve with the topical application of tretinoin.
Surgical Care
Actinic purpura may respond to antiaging therapy, including laser therapy for vascular and pigmented lesions in aging skin. [19, 20] A long-pulsed, frequency-doubled Nd:YAG laser may be suitable (532 nm). [21]
Activity
Advise patients with actinic purpura to limit their sun exposure by applying sunscreen daily or by avoiding sun exposure altogether. Instruct patients to minimize any trauma to the skin where the purpuric lesions are present.
Prevention
Actinic purpura can be prevented by using lifelong sun protection. Advise patients to adhere to the following precautions, starting at the earliest possible age. Avoid sun exposure when the most damaging rays are present (ie, from 10 am to 3 pm). Wear clothing at all times while outdoors to serve as barrier protection from the sun's UV rays. Apply sunscreens that protect against UV-A and UV-B radiation daily, especially to areas of the skin that are not covered by barrier protection.
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Actinic, or senile, purpura. Courtesy of José Reynaldo da Fonseca (own work), via Wikimedia Commons.
