Why Queen Elizabeth’s hand turned purple: What we know now

That final photo of Queen Elizabeth II at Balmoral, just two days before she passed away in September 2022, sparked a global wave of concern that honestly overshadowed the political significance of the meeting itself. She was there to appoint Liz Truss as Prime Minister. But nobody was looking at the new PM. Everyone was looking at Queen Elizabeth's hand. Specifically, the back of her right hand, which appeared bruised, dark, and distinctly purple. It was a jarring image for a public used to seeing the monarch as a constant, unchanging force of nature.

People started speculating immediately. Was it a fall? Was it a medical treatment? The reality of aging in the public eye is brutal, especially when every pixel of a photograph is analyzed by millions of amateur sleuths and medical professionals alike on social media. We’re talking about a woman who was 96 years old. At that age, the skin becomes paper-thin. You’ve probably seen it in your own grandparents—that fragility where even a slight bump or a routine medical procedure leaves a mark that looks way worse than it feels.

The medical reality of the Queen Elizabeth hand bruising

Medical experts, including those not directly treating the Royal Family but familiar with geriatric care, pointed toward a few likely culprits. One of the most common reasons for that kind of discoloration is something called senile purpura. It sounds scary, but it’s basically just easy bruising because the blood vessels and the skin lose their elasticity over time. When you’re nearly a century old, the connective tissue that protects those tiny capillaries just isn't there anymore.

Another very real possibility involves medical intervention. If the Queen was receiving intravenous (IV) fluids or medication—which wouldn't be surprising given her "episodic mobility problems" that the Palace had been talking about for months—a cannula would likely have been placed in the back of the hand.

It's the easiest spot for a nurse to find a vein. But it’s also the spot most prone to significant bruising in the elderly.

Think about the context of those final days. She was 96. She had recently recovered from COVID-19. She was struggling with her back. She was grieving Prince Philip. The physical toll of just existing at that age is immense. The Queen Elizabeth hand phenomenon wasn't a single "event" or a secret injury; it was the visual manifestation of a body finally reaching its limit.

Interestingly, this wasn't the first time the public noticed something was up with her hands. Back in 2019, a photo from a meeting with the Jordanian royals showed a similar purple hue. The Palace never commented then, and they didn't comment in 2022. That’s just the "never complain, never explain" mantra in action. They let the image speak for itself, focusing instead on the fact that she was still standing, still smiling, and still doing her job until the very end.

Peripheral cyanosis vs. simple bruising

There was a lot of chatter about "peripheral cyanosis." This is a fancy way of saying there isn't enough oxygen in the blood reaching the extremities. When your circulation slows down—common in heart failure or as the body begins the natural process of shutting down—your hands and feet can turn blue or purple. It’s a chilling thought, but it fits the timeline.

Dr. Deb Cohen-Jones, a GP based in Australia, noted at the time that the bruising could indicate multi-organ failure. When the heart can’t pump effectively, it prioritizes the core organs. The hands are the first to lose out.

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• Age-related skin thinning: The dermis loses about 20% of its thickness as we age.
• Anticoagulants: Many seniors are on blood thinners like aspirin or warfarin to prevent strokes. These make any tiny leak from a vessel look like a massive hematoma.
• The "Death Bloom": A colloquial, somewhat poetic term for the mottling of skin that occurs as circulation fails in the final days of life.

The Queen's hands were always a point of interest, mostly because of the way she used them. The "Windsor Wave," the way she clutched her Launer handbag, the way she wore her white gloves. Those gloves weren't just a fashion choice; they were practical. They protected her hands from the hundreds of people she had to shake hands with every week. They prevented germs. They hid the inevitable spots and veins of age. But on that day at Balmoral, she wasn't wearing them.

The symbolism of the ungloved hand

Why did she go without gloves for the Liz Truss meeting? It felt intimate. It felt vulnerable. It was one of the few times we saw the "real" her—not the polished, gloved icon, but an elderly woman doing her best to maintain the dignity of her office while her body was clearly failing.

History will remember that photo. Not just for the political transition, but for the sheer grit it showed. Most people at 96 with hands that look like that would be in bed. She was standing in a drawing room, leaning on a cane, but standing nonetheless.

We should also talk about the "Long Covid" factor. While the Palace played it down, the Queen admitted that the virus left her feeling "very tired and exhausted." COVID is known to affect vascular health. It’s entirely possible that the lingering effects of the virus exacerbated her circulatory issues, making the Queen Elizabeth hand discoloration even more prominent than it might have been otherwise.

What this means for understanding geriatric health

Looking at the Queen’s hands provides a lesson in empathy for how we view the elderly. We often want our leaders and icons to be immortal. We get shocked when we see the "purpura" or the thinning skin because it reminds us of our own mortality.

If you are caring for an elderly relative and you see similar bruising, don't jump to the most dire conclusion immediately. While in the Queen's case it was a precursor to her passing, for many, it's just a side effect of a life long-lived.

Actionable insights for monitoring hand health in seniors

If you notice sudden, dark bruising on a senior's hands:
Check their medications. Are they on new blood thinners? This is the number one cause of "mystery" bruises.
Assess for trauma. Did they use a walker or cane that might be putting pressure on that area? Sometimes the very tools used for mobility cause the bruising.
Monitor temperature. Are the hands cold to the touch? Cold, purple hands often signal a circulation issue that needs a doctor's look, whereas warm, purple hands are usually just a bruise.
Hydration matters. Dehydrated skin is even more prone to tearing and bruising. Ensure they are getting enough fluids to keep the skin as "plump" as possible.
Check for "pitting edema." If you press the skin and the indent stays, that’s fluid retention, which often goes hand-in-hand with the circulatory issues that cause discoloration.

The Queen died of "old age," according to her death certificate. It’s a simple, almost poetic explanation for a complex biological shutdown. Her hands told the story that the Palace officials wouldn't put into words: she was tired, she was frail, but she was there. She worked until the very last moment her body allowed, purple hands and all. It wasn't a "medical mystery" so much as it was the biological reality of a 96-year-old woman finishing her final task.

To better understand these signs in your own life, pay attention to skin integrity. Use high-quality emollients containing ceramides to help strengthen the skin barrier in older adults. If bruising appears without any known impact or medical procedure, consulting a vascular specialist can rule out more serious underlying conditions like deep vein thrombosis or advanced peripheral artery disease.