Long term and repeated exposure to sunlight, especially ultraviolet light, can cause a variety of cosmetic and medical problems related to the skin, commonly referred to as sun damage. Sun damage can affect any area of the skin because of excessive exposure to the ultraviolet (UV) rays of the sun. Sun damage most commonly occurs on the face, hands and arms, and may lead to sunspots, age spots, rough skin and wrinkles. Years of sun exposure can also lead to premature aging and skin cancer. Some individuals may notice skin lesions that are a form of actinic keratosis, which is a precancerous skin condition that develops from years of sun exposure.
What are the signs of photoaging?
Unlike normal, chronological aging, which is dictated by age and genetics, photoaging happens when ultraviolet light from the sun and/or tanning beds permanently damages the skin’s structure. To see the difference between chronological aging and photoaging, compare skin on an area of your body that is not exposed to the sun with the skin on your face.
Signs of photodamage begin in the teens to early twenties. Symptoms include the following:
- Wrinkling
- Pigmentation changes such as age spots, liver spots (solar lentigines) and freckles
- Loss of skin tone (decreased elasticity)
- Rough, uneven skin texture
- Broken capillaries (spider veins), usually around the nose and chest
- Redness and blotchiness
Who is susceptible to photoaging?
Everyone is susceptible to photoaging, but how much photodamage you sustain depends on how much unprotected sun exposure you’ve had over time, in addition to your skin type and geographical factors, including your latitude and the climate. In general, lighter skin is more susceptible to photoaging and skin cancer. Darker skin can also be photodamaged and develop skin cancer, but the more likely outcome is that the skin will develop uneven dark patches (melasma). Providers use the Fitzpatrick’s Scale to determine skin’s phototype (or skin color) and assess photodamage risk:
- Type 1—Pale skin, light-colored eyes, blond or red hair. Always burns, does not tan.
- Type II—Fair skin with light-colored eyes. Burns easily but may tan.
- Type III—Medium light skin that initially burns and then tans.
- Type IV—Light brown skin that tans with minimal burning.
- Type V—Medium brown skin that rarely burns.
- Type VI—Dark brown or black skin that tans easily and never burns.
What can providers do to treat photoaging?
While photodamage cannot be removed completely, the following treatments can often help minimize it:
- Lasers. There are numerous laser modalities that can address the signs and symptoms of photoaging. Fractional resurfacing lasers use laser energy to rejuvenate skin and minimize the appearance of brown spots and fine lines, as well as improve texture and the appearance of enlarged pores. Other lasers, such as picosecond and nanosecond lasers, can address pigmentation concerns.
- Chemical peels. By applying a chemical substance such as trichloracetic acid or glycolic acid to the skin, dermatologists can remove brown spots and actinic keratoses and improve the tone and texture of photoaged skin.
- Photodynamic therapy. This treatment helps remove precancerous spots that can result from sun exposure. The provider applies a topical medication on the skin and then uses a blue or red fluorescent light to activate the medication, which destroys precancerous cells but preserves normal cells.
- Topical medications. Certain medications such as a topical retinoid medication (like tretinoin) can be prescribed to even out your skin tone and address roughness and fine lines that result from photoaging.
- Cryotherapy. Liquid nitrogen is sometimes used to freeze noncancerous age spots or actinic keratoses, and after a few days, the spots become dark and shed off.
How can you prevent photodamage?
It’s never too late to practice good sun protection to prevent future photodamage. We recommend using a broad-spectrum sunscreen, which will shield skin from both UVA and UVB rays.
- Look for a sun protection factor (SPF) of 50 or higher. Water-resistant formulas are encouraged. Reapply every two hours or sooner if swimming or exercising
- Wear a hat in the sun
- Wear long sleeves and long pants
- Avoid tanning beds and salons