Sun Damage & Photoageing

Sunlight (UV light) is the number one factor responsible for skin ageing

Genetics also plays a part on how quickly and how much our skin ages. Other factors include smoking, facial expressions and gravity.

To prove this fact, just compare the skin on your face or back of your hands with the skin of your buttocks!

Sun exposed skin develops wrinkles, dryness, coarse texture, uneven pigmentation, shallow tone.

Unexposed skin is firmer, smoother, more supple and more even in tone and pigmentation.

Photoageing is a slow process, but in people who have had a lot of sun exposure it can start to occur as soon as in their 20s.

Sun exposure can be intentional, for example sunbathing whilst on holiday or using sunbeds. But it can also be opportunistic , for example from outdoor occupations (farmers, fishermen, builders) or hobbies (gardening, walking, sailing, golf, tennis, etc.)

As well as accelerating skin ageing, the sun can also cause damage on the skin DNA. Some of this will recover, and the skin will renew itself normally. However, some cells may not fully recover, causing lesions consistent with sun damage. We call these actinic (AK) or solar keratoses (SK). In the UK, 24% of people over 60 have one or more of these lesions, and the percentage increases with age.

Actinic keratoses manifest themselves as small ( less than 1cm) reddish-grey scaly lesions that appear on sun exposed areas. They are common on the face, scalp ( particularly balding men), ears, V of the neck, arms and forearms, back of the hands, legs and feet. They are technically precancerous lesions ( skin cancer precursors). They are often not painful and don’t produce any symptoms.

The majority of actinic keratoses lesions won’t become skin cancers, and in fact can revert back to normal ( up to 25% on some studies). However, a minority ( 1% per year) can develop into a form of skin cancer called Squamous Cell Carcinoma (SCC). This means that the more lesions a person has, the more likely it is that one of them will become a skin cancer over time.

Some people with a lot of sun damage develop what we call field change (or field damage) . This means that a whole area of skin is sun damaged, and at risk of developing skin cancer. These areas of skin are very unstable.

Sunscreens have been proved in some studies to also revert sun damage, as well as preventing further damage and progression to skin cancer.

It is important to treat sun damage, as this will reduce your overall risk of skin cancer. There are several available treatments, from topical creams, to cryotherapy (freezing treatment) to PTD ( photodynamic therapy) and surgery. The choice of treatment will depend on a number of factors, including the type and extent of the lesions, and your overall risk of skin cancer. We often use a combination of treatments over a period of time.

Cosmetic photoageing can also be treated by different means, from creams to even out skin tone, to laser treatments and chemical peels.

We can perform an overall analysis of your skin and prescribe the right regime for you, as well as spot any potentially troublesome lesions. Call us today for an appointment.

Sun protection rules

Remember the following principles:

Stay away from direct sunlight between 11am-3pm

Stay under the shade

Cover up with tight woven clothes (if you can see through them, the sun gets to your skin)

Wear a broad brimmed hat in the sun

Use sun protection

The recommended sun protection will depend on the weather and your skin type. In the UK, most people has skin types I-III, so an SPF of 30 and above from April to October, and 15 in the winter would be appropriate. Of course, this may need to increase if going on holiday or travelling to sunnier climes. However, some sun protection is better than none, and the important thing is to apply it often and in enough quantity.

Make sure you use a sunscreen with a broad spectrum of protection. This means an SPF (sun protection factor), which protects you from UVB and prevents burning. However, you also need UVA protection. This is displayed by a star rating, the maximum being 5. Choose as high a rating as possible.