The Medical Mystery Of Queen Elizabeth II's Hands: 5 Key Facts About The Dark Spots And Swelling

The health of Queen Elizabeth II was a topic of intense global interest during her extraordinary 70-year reign, and in the final months of her life, a particular focus fell on the appearance of her hands. Specifically, the dark spots and notable swelling seen in photographs from her final public engagement—just two days before her death on September 8, 2022—sparked widespread speculation and concern among royal watchers and medical professionals alike. As of late 2025, the true, official medical cause was never confirmed by Buckingham Palace, but expert analysis provides compelling, up-to-date theories that shed light on the monarch’s final days. The images, taken as she formally appointed Liz Truss as the new Prime Minister at Balmoral Castle, provided a poignant, yet subtle, indication of the declining health of the 96-year-old sovereign. The visual evidence of the discoloration and puffiness on her hands is now viewed as one of the last public signs of the physical challenges the Queen was enduring, ultimately leading to her passing from "old age" as officially listed.

Queen Elizabeth II: Full Biographical Profile

Her Majesty Queen Elizabeth II, born Elizabeth Alexandra Mary, was the longest-reigning monarch in British history and a revered figure globally. Her life was defined by duty, service, and an unwavering commitment to the Commonwealth. The following is a brief profile of her life and reign:

• Full Name: Elizabeth Alexandra Mary Windsor
• Born: April 21, 1926, in Mayfair, London, England
• Died: September 8, 2022, at Balmoral Castle, Aberdeenshire, Scotland
• Parents: King George VI (Prince Albert, Duke of York) and Queen Elizabeth The Queen Mother (Elizabeth Bowes-Lyon)
• Spouse: Prince Philip, Duke of Edinburgh (m. 1947; d. 2021)
• Children: Charles III (King), Anne (Princess Royal), Prince Andrew (Duke of York), Prince Edward (Earl of Wessex)
• Reign: February 6, 1952 – September 8, 2022 (70 years and 214 days)
• Successor: King Charles III

The Medical Theories: Dark Spots and Bruising Explained

The dark, bruised-looking patches visible on Queen Elizabeth II’s hands in her final photographs are a common phenomenon in elderly individuals, particularly those in their 90s. Medical experts, analyzing the images, largely converged on a few key, non-life-threatening explanations that are strongly associated with advanced age.

Senile Purpura (Actinic Purpura)

The most widely accepted medical theory for the dark spots is Senile Purpura, also known as Actinic Purpura or Solar Purpura. This condition is characterized by dark purple blotches, or ecchymoses, on sun-exposed areas, most commonly the back of the hands and forearms.

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• Cause: Senile Purpura is not a bruise in the traditional sense, but rather a result of increased vessel fragility.
• Mechanism: Over decades of sun exposure, the connective tissue (collagen and elastin) in the skin's dermis thins and atrophies. This makes the tiny blood vessels (capillaries) beneath the skin incredibly fragile.
• Symptom: Even minor trauma—such as a slight bump or pressure from a handshake—can cause the vessels to rupture, leading to blood leaking into the surrounding tissue and creating the distinct dark purple or brown patches.
• Relevance to the Queen: Given her age and the location of the marks, this is considered the most probable explanation for the dark discoloration observed on the late monarch's skin.

Peripheral Edema and Swollen Fingers

In addition to the dark spots, the Queen’s hands often appeared noticeably swollen in her later years. This condition is medically referred to as Peripheral Edema, which is the retention of excess fluid in the limbs, often the hands and feet. While swelling can be benign, it can also be a symptom of more serious underlying health issues.

• Possible Causes: Fluid retention can be caused by various factors, including the side effects of certain medications, poor circulation, or simply sitting in the same position for extended periods.
• More Serious Concerns: In older adults, prolonged edema can sometimes be a sign of underlying heart, liver, or kidney problems, as these organs play a crucial role in regulating fluid balance in the body.
• Royal Precedent: Interestingly, the issue of swollen hands has also been a topic of public discussion regarding her son, King Charles III, whose "sausage fingers" have been widely noted, suggesting a possible hereditary or common age-related issue within the Royal Family.

The Health Timeline: A Glimpse into the Monarch's Final Year

The appearance of Queen Elizabeth II's hands in her final days was part of a broader, well-documented decline in her mobility and general health that began in late 2021. The public scrutiny of her hands served as a visual marker of the physical toll her long life and duty had taken.

Mobility Issues and Missed Engagements

Starting in late 2021, the Queen began to experience significant mobility issues, which led to a series of missed public engagements. This shift was a clear sign that her robust health, which she had enjoyed for most of her life, was finally waning.

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• November 2021: The Queen was forced to miss the annual Remembrance Day Service at the Cenotaph due to a back injury, marking one of the first major public indications of her physical frailty.
• February 2022: She tested positive for COVID-19. Although the symptoms were described as mild, the illness reportedly left her feeling "very tired and exhausted," further contributing to her overall decline.
• Final Weeks: Throughout the summer of 2022, the Queen remained at Balmoral Castle in Scotland, opting to hold the traditional meeting with the outgoing and incoming Prime Ministers there, rather than traveling to Buckingham Palace, a decision necessitated by her ongoing mobility challenges.

The Poignant Final Photograph

The image of the Queen shaking hands with Liz Truss on September 6, 2022, is historically significant as her last official photograph. The visual contrast between her bright smile and the dark, bruised appearance of her right hand was jarring for many observers. This hand, which had waved, signed countless documents, and shaken hands with world leaders for seven decades, became a final, subtle symbol of her dedication to duty until the very end.

While the official cause of death was simply "old age," the visible signs of peripheral vascular changes and senile purpura on her hands were, for many, a clear, if unofficial, indication of the advanced systemic aging and frailty that led to her peaceful passing just 48 hours later at her beloved Scottish retreat, Balmoral. The enduring image of her hands serves as a powerful reminder of the physical realities faced by even the most powerful figures as they reach the end of a long life.

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