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Actinic Purpura Treatment & Management

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
Updated: Jun 22, 2016

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 lasers therapy for vascular and pigmented lesions in aging skin.[14]



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.



Actinic purpura is a benign condition and does not have serious complications. The lesions may be emotionally distressing to patients because of the cosmetic disfigurement of the skin.



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.

Contributor Information and Disclosures

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public Affairs and Administration

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, New York Academy of Medicine, American Academy of Dermatology, American College of Physicians, Sigma Xi

Disclosure: Nothing to disclose.


George Kihiczak, MD Clinical Associate Professor, Department of Dermatology, New Jersey Medical School and University Hospital

George Kihiczak, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Medical Society of New Jersey

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Jeffrey J Miller, MD Associate Professor of Dermatology, Pennsylvania State University College of Medicine; Staff Dermatologist, Pennsylvania State Milton S Hershey Medical Center

Jeffrey J Miller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Society for Investigative Dermatology, Association of Professors of Dermatology, North American Hair Research Society

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Julie R Kenner, MD, PhD Private Practice, Kenner Dermatology Center

Julie R Kenner, MD, PhD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, Vinay Arya, MD, to the development and writing of this article.

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