Sun Damaged Skin

About Skin

The skin has many important functions. It protects us from disease, injury and changes in temperature.

The skin has two main layers. The outer layer is called the epidermis. It contains basal cells and squamous cells, which link tightly together to form a barrier, and melanocytes, which produce melanin, the substance that gives the skin its colour. The layer underneath the epidermis is called the dermis. The dermis contains the roots of hairs, glands that make sweat and oil, blood and lymph vessels and nerves. Below this is a layer of fat.

What happens to the skin in the sun?

Each time your unprotected skin is exposed to ultraviolet (UV) radiation, it causes changes to take place in the structure of the cells and in what they do. Over years of exposure to UV radiation, the skin becomes permanently damaged. The damage worsens with more UV radiation exposure.

These changes are often described as “premature ageing”, but they are, in fact quite different to normal ageing in the skin. In old age, the skin that is not exposed to the sun is smooth, without spots or blemishes. It is a little thinner than younger skin, but there are relatively few wrinkles and it remains fairly firm.

Skin that has been exposed to the sun, on the other hand, becomes thickened, rough and leathery. Gradually, over 20 to 40 years, it acquires many blotches and blemishes and fair skin particularly may become yellowish. It becomes loose, and it is covered with fine wrinkles broken by a number of deep creases. These effects are seen especially on the skin that gets the most sun – the face, the back of the neck, the backs of the hands and the arms and neckline.

The changes to your skin from sun damage range in a spectrum. At one end of the spectrum is what can be called photodamage where there may be a change in the colour (pigmentation and redness), contours (wrinkles) or texture (dry and rough) of the skin.

More severe sun damage may then manifest as skin cells damaged to the extent they are more likely to develop into skin cancers. These precancerous areas of skin are commonly called sunspots but medically are termed solar keratoses. The most serious level of sun damage to the skin is when the skin develops cancerous growths i.e. skin cancers.

How can Sun Damaged Skin be treated?

Treatment of sun damaged skin depends on the degree of damage and the level of improvement required. In general the best results are achieved by a combination approach. Topicals are important to both slow the rate of further damage ( sunscreen), replace hydration ( moisturiser) and help with repair (cosmeceuticals such as Retinoic acid). Dermal treatments such as microdermabrasion and peels can help exfoliate dead skin cells and improve skin tone and texture. Laser treatments with the Fraxel 1927 and the Picosecond 755 can target excessive skin pigment whilst the Excel V and V Beam can target unwanted redness caused by increased vascularity. Skin needling including with fractional radiofrequency (Infini treatment) can produce collagen remodelling to improve scarring and wrinkling. Photo Dynamic Therapy can be used to treat precancers on the skin. Injectables such as Botox to soften and remove unwanted wrinkles and Dermal fillers to replace skin volume that has been lost because of sun damage may be appropriate for some patients.

WHAT DAMAGE DOES THE SUN CAUSE TO MENS SKIN?

The skin serves as the protective barrier to protect the body from sun damage. Prolonged or excessive unprotected sun exposure can cause damage to the skin in the short term with redness, sunburn and increased pigmentation such as freckling. In the long term the sun can damage all the structures in the skin in the process called Photo-damage.

When the supporting structures of the skin such as Collagen, Elastin and Hyaluronic acid are damaged by the sun it results inthe skin becoming dry and coarse with premature lines and wrinkles developing. This is called Photoaging, withthe appearance of your skin on sun exposed areas such as the face, neck and hands, looking much older than you actually are.

Damage to the pigment cells in the skin results in skin discolouration withfreckling and increased pigmentationoccurring but can also result in the appearance of white spots on the skin (Hypopigmentation). Damage to superficial blood vesselsresults in increased vascularity and redness which can appear as discrete red capillaries (Broken Capillaries)and/or diffuse redness.

The sun importantly can damage the genetic material of skin cells (DNA)and this is what results in the development of skin cancers. Australia has the highest rate of skin cancer in the world and 2 in 3 Australian men develop some form of skin cancer before they turn 70. If skin cancers are recognised and treated early they usually respond very well to treatment but if left untreated they can become a serious health issue. Prevention is the key and use of appropriate sunscreen is very important but you should never rely on sunscreen alone.

HOW CAN SKIN REDNESS BE TREATED IN MEN?

When the skin redness is due to discrete broken capillaries then laser treatment with the EXCEL V or the DIODE 532 laser is the best option to trace out and remove these unwanted blood vessels. When skin redness is more diffuse then treatment with either the BBL or the Laser Genesis is generally recommended. It is not uncommon to need follow up maintenance treatments to keep skin redness from sun damage under control.

HOW CAN SKIN PIGMENTATION BE TREATED IN MEN?

Pigmentation changes can be localised in the form of brown spots (Solar Lentigines) or more diffuse uneven brown pigmentation. Localised brown marks can be spot treated by laser treatment but it is important to realise that a brown spot should not be treated by laser if there is any suspicion that it could be a skin cancer. If there is any recent change to brown spots in terms of size, colour, shape or symptoms of itchiness or bleeding do not have laser treatment on them until you have a skin check by a medical practitioner. If you have a personal history of Melanoma or a first degree relative does then we would advise not to treat Brown spots by laser.

Diffuse uneven pigmentation can be improved by topical creams such as Niacinamide (Vitamin B3) or Kojic acid, prescription creams such as Hydroquinone and Dermal treatments such as Peels. For more severe pigmentation from sun damage treatment with laser based treatments needs to be considered notably Picotoning with the PICOSURE laser or non-ablative fractional resurfacing with the FRAXEL1927 laser.

HOW CAN WRINKLES AND LINES BE TREATED IN MEN?

There is a range of treatment options to improve lines and wrinkles caused from a combination of sun damage and aging ie Photoaging. The majority of men when they present with Photoaging on the face already have significant lines and wrinkles and are past simple topical and surface dermal treatments. A combination approach of Anti Wrinkle injections to stop over activity of facial muscles especially on the forehead and around the eyes, Dermal fillers to replace lost volume and treatments to stimulate new collagen formation such as the INFINI are often needed.

HOW CAN CHANGES IN SKIN TEXTURE BE TREATED IN MEN?

Skin texture can become dry and thickened with sun exposure over time and the use of skincare products such as a daily moisturiser to replenish moisture and a daily sunblock to slow the rate of further sun damage are important. The use of topical Vitamin A can help repair some of the damage that has already been done. Dermal treatments such as Microdermabrasion, Peels, Laser toning and Picotoning can help exfoliate dead skin cells and improve skin texture and reduce pore size.

Solar Keratosis is the name given to small scaly patches of skin that can develop as a result ofsundamage. Even one bad sunburn when you were young can result in these occurring later in life. Solar Keratoses are regarded asprecancers and it is estimated that about 10% can go on to become a skin cancer. When they are only a fewSolar Keratoses they are usually treated by freezing with liquid nitrogen or applying a prescription cream. When there are multiple Solar Keratoses then laser treatment or Photodynamic Therapy may need to be considered.

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