You can reverse sun damage on your skin—a dermatologist explains
How to tell if your sun damage is serious—and treat it.
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After a long summer spent at the beach, out by the pool, or frolicking from place to place, you may see your tan lines and freckles as evidence of a good time. As long as you applied (and reapplied) sunscreen throughout those days, you may not think much about the impact the sun’s rays had on your skin. Over the years, though, even minor sun damage—which is what those freckles and tan really are—can leave a long-lasting mark in the forms of blotchy discoloration, fine lines, and wrinkles.
To explain how you can identify sun damage on your skin and what you can do about it, we spoke with Dr. Sandhya Deverapalli, a dermatologist and the director of chemotherapy and transplant dermatology at Tufts Medical Center in Boston. It turns out there are two main types of sun damage, health-related and cosmetic, and it’s important to identify which you have in order to treat them.
What is health-related sun damage?
Of the two types of sun damage, the form that could indicate underlying issues that can affect your health, in particular skin cancer, is the most important to have a doctor examine.
But first, take a good look at your skin to determine if there's anything you need to bring to the attention of your doctor. “Look out for non-healing wounds on their skin; pink, sandpaper-textured spots that feel really rough to the touch that are bright pink in color; or really dark spots that have been changing in color and size,” Deverapalli says. All of these signs can show up anywhere that the skin was exposed to the sun, but Deverapalli says the pink, sandpaper-like spots usually occur on the forehead, scalp, nose, or forearms.
Oftentimes, health-related sun damage is accompanied by cosmetic sun damage, too. If you have any questions about your skin, and especially if you suspect health-related sun damage, make an appointment with a dermatologist ASAP for a full skin checkup.
How do you treat health-related sun damage?
All health-related sun damage requires treatment from a dermatologist. “[The doctor] should either use liquid nitrogen to freeze these spots off or they would give you a prescription cream to apply at home that can also destroy these precancerous spots,” Deverapalli says. “Or they could recommend something called blue light treatment that happens, again, in a doctor’s office to get rid of these spots.”
After receiving treatments for health-related sun damage, you can expect some scabbing, discomfort for seven to 10 days, and then an improvement—the spot should almost fade completely—in about one or two months. However, Deverapalli says that treating a spot can cause sun damage “brewing in the background [that] never really manifested” to show up. To maintain the effects of the in-office treatment, the doctor may prescribe a cream or retinoid to apply at home. Your doctor should also request regular checkups to ensure your skin remains healthy.
What is cosmetic sun damage?
Cosmetic sun damage presents as freckled spots (these will be light tan spots, not dark and well-defined like the moles), white spots, fine lines, wrinkles, or patches of red skin with broken blood vessels. Fine lines, wrinkles, and broken blood vessels are more common on the chest and neck, Deverapalli says. And white spots usually occur on the forearms and legs of older people exposed to the sun over many years. “These are some of the things that are cosmetically non-appealing to the patients,” Deverapalli says.
Cosmetic sun damage can go untreated, though it’s always a good idea to have your dermatologist perform a skin check to ensure that your skin is healthy. If you’re bothered by cosmetic damage, there are treatment methods for it.
How do you treat cosmetic sun damage?
Treatment depends on the extent of sun damage. For example, Deverapalli says, someone in their 20s with newer sun damage would require a less intense treatment than someone in their 60s with an accumulation of sun damage over many years. From least to most aggressive, the most common treatment options include:
Retinoids: The first and least invasive option is using a prescription retinoid, such as tretinoin, to reduce the fine lines and wrinkles and fade dark spots. Retinoids work better as prevention methods than treatments for already-developed fine lines or wrinkles, which means they may not offer the results you want. “I’d really have to assess someone at that point to make sure even a prescription-strength would help them with some of the wrinkles they have, but overall, I would say that wrinkles that have already set in and lines that have already set in would probably need a procedure to take care of it.” Fillers or Botox could act as a supplemental treatment alongside a retinoid, too. Using a retinoid cream alone will take about three to four months for improvements in texture and tone.
Chemical peels: For younger people with newer sun damage that mostly consists of freckles, a chemical peel is a great option. Chemical peels cause the skin to blister and peel off, resulting in newer, smoother skin coming to the surface. You should see results in about four weeks after treatment. A chemical peel is best suited for lighter-skinned patients, as darker-skinned patients are more likely to experience a reaction that causes dark patches on the skin, which would be counterproductive.
Laser treatments: For older patients that have accumulated sun damage over many years and have a lot of freckling or discoloration, a laser treatment that removes the layer of damaged skin is a better option. Depending on the laser used and the extent of the damage, you should see results in two to three weeks, and the treatment may require a few sessions to achieve your desired results. Similar to chemical peels, lasers present a risk of altering the pigment of darker skin tones, but they can work well if done by skilled hands.
What if you have more than one kind of sun damage?
Whether you want to treat cosmetic sun damage is at your discretion, as there is no danger with leaving it alone. However, precancerous sun damage poses a risk if untreated. If you have both, you can address each with separate treatments. “You have to make that distinction [between cosmetic and health-related damage] because the lasers and chemical peels will not take care of the precancerous spots like the other modalities of treatments will,” Deverapalli says. Health-related sun damage should take priority, but you can treat the two alongside each other.
How can you prevent future sun damage?
The most important thing you can do to prevent sun damage is apply sunscreen to any skin that’s exposed to the sun. “Broad-spectrum sunscreens are very important, especially when you’re trying to prevent pigmentation,” Deverapalli says. “It’s important to have physical blockers, which are zinc oxide and titanium dioxide, as part of the sunscreen.” Coat exposed skin 20 minutes before going out with broad-spectrum sunscreen of at least SPF 30 and reapply every two hours while you’re still in the sun—more frequently if you’re sweating or swimming.
In addition to sunscreen, you can purchase sun-protective clothing. Deverapalli recommends purchasing items with an ultraviolet protection factor, or UPF, of 40 or greater. You’ll still need SPF for exposed skin, but the clothing can limit how much you need to slather up.
While it won’t protect you from a sunburn like an SPF, an antioxidant serum containing vitamin C is a great addition to your skincare routine prior to sun exposure. Antioxidants protect the skin against free radicals from the sun’s UV rays that can cause premature aging. Antioxidants also can reduce signs of sun damage by brightening the skin and smoothing its texture. “The antioxidant protection is more for aesthetic use rather than actually protecting you from skin cancer, so it’s something that I would only recommend for the face or cosmetically sensitive areas,” Deverapalli says.
As with any skin changes or conditions, consult a dermatologist if you’re unsure of how to properly prevent, identify, or treat sun damage.
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