Long lazy youthful days spent lounging in the sun once appeared as a deep, bronze tan. But fast-forward 20 years and look again. Evidence of those carefree and unprotected hours in the sun now show up on your face, chest, neck and arms. It shows up as sun-damaged skin.
The signs appear as fine to medium wrinkles, sagging skin, freckles, uneven pigmentation, and dark spots. Sometimes they show up as precancerous lesions or skin cancer.
The first step in reversing sun damaged skin is preventing further damage. “A good broad-spectrum sunscreen that protects from UV exposure is the first and most important step for people to take,” says E. Victor Ross, MD, a board-certified dermatologist at Scripps Clinic Carmel Valley.
Preventing sun damage is easier than reversing it. Measures include wearing protective clothing, using sunscreen and avoiding tanning beds.
“Sun damage can lead to skin cancer,” Dr. Ross says. “Prevention is the best way to deal with sun damage and reduce your risk of skin cancer.”
“Proper skin care means taking notice of any changes,” Dr. Ross adds. “It means knowing the signs and symptoms of skin cancer.”
People who are fair skinned or have a family history of skin cancer should be extra vigilant about sun protection. Southern Californians in general should be careful about sun exposure since they are exposed to more intense sunlight more days of the year than people living in more temperate climates.
“Even a good sunblock is not as effective as simply minimizing your sun exposure, particularly in places like San Diego,” Dr. Ross says. “We all enjoy the sun here, but any time you have an opportunity to do something later in the day or every early in the day, taking advantage of the relative darkness will reduce your skin cancer and photoaging risk.”
Interventions for sun damage vary. They range from daily use topical creams and gels to chemical and mechanical skin peels and laser treatments. These treatments can temporarily fade uneven pigment, smooth roughened or wrinkled skin, shrink pores and even restart collagen production.
“We typically see three kinds of sun damage in San Diego,” says Dr. Ross. “Melasma, which are tan or brown spots on the forehead and cheeks, is the most common. There are also red and brown age spots, broken blood vessels as well as wrinkling and sagging of the skin.”
These compounds, chemically derived from vitamin A, encourage skin cells to slough off and renew themselves, improving skin cell turnover cycles. They also stimulate collagen production, lighten brown spots and, in theory, reduce the size of pores.
These substances slow the skin’s degeneration due to the production of rogue chemicals, such as free radicals, that cause visible signs of damage. Antioxidants can slow the signs of aging, reduce UV damage to skin and help reduce the breakdown of collagen.
Sun damage slows the rate at which skin cells turn over or replace themselves. This causes dull, dry skin, uneven skin tone, and even blemishes and clogged pores. Chemical exfoliants can stimulate faster skin cell turnover.
Whitening or brightening cosmetics typically include hydroquinone, an ingredient shown to have skin-lightening properties. Used in conjunction with a retinoid, these can lighten but not completely remove superficial blemishes, uneven pigmentation and sunspots.
A chemical peel is a non-surgical procedure performed by a dermatologist using various solutions to improve skin appearance. The depth of treatment varies. It can be superficial, medium or deep depending on skin type and the cosmetic and therapeutic goal.
Peels are used to remove the outermost layers of the skin so new, clear skin can come to the surface. In many cases, removal will take with it areas of uneven pigmentation, precancerous lesions and fine lines. Chemical peels can either be performed in a series or as a one-time treatment, depending on the peel depth.
“Downtime for superficial peels is minimal,” explains Dr. Ross. “You may experience redness and swelling with a deeper peel. Medium and deep peels require longer recovery time. After any chemical treatment, strong protection is a must.”
Several kinds of lasers can be used on nearly any body surface to help reduce the appearance of sun damage. “Generally, the laser treatments produce the best results when we target the face, neck, and chest,” says Dr. Ross. “They typically take less than 30 minutes, with varying downtime depending on laser type.”
Laser therapy can treat red and brown lesions. “The optimal scenario is when the patient is light. Most of these devices work best when there is significant contrast between the red or brown lesion and the background skin,” Dr. Ross says.
Also referred to as photo rejuvenation, these devices, such as IPL, can improve skin texture, redness, broken veins, blotchiness, and brown spots. “There is no better technology for blood vessels than a green light laser,” says Dr. Ross. “Creams and chemical peels may not be able to offer the same results.”
These lasers create tiny wounds, deep in the skin. As they heal, the skin re-emerges with a smoother, tighter appearance. Fractionated lasers stimulate the natural healing process to create new collagen.
These are more aggressive, deeper lasers that vaporize the top layer of skin. They are used for significant damage ranging from deeper pigmentation and growths to unevenness and deep lines and wrinkles. These lasers require a longer and more intense recovery period.
Dr. Ross says protecting your skin from sun damage is an ongoing process. “Unless one starts to practice sun protective behaviors, individuals will continue to be exposed to skin-damaging UV rays,” he says. “Prevention is important but if you’re concerned about skin damage, play it safe and check in routinely with your dermatologist.”
Lesions that persist, bleed or change should be motivation for an early dermatology appointment.