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All About Sun Damaged Skin

"Why does too much sun exposure damage the skin of a person? "
By: Ma. Jocelyn A. Niere-Quidlat, MD, FPPSAll About Sun Damaged Skin

The heat of the sun causes drying of the unprotected skin and decreases or even depletes the natural oils that lubricate the skin. Added to that, the ultraviolet radiation of the sun can cause burning and long-term changes in the structure of the skin. There are two types of ultraviolet radiation from the sun. One is the UVA (320-400 nm wavelength) and the second one is UVB (290-320 nm wavelength. The sun contains more UVA than UVB. Exposure to UVB causes sunburn but exposure to very large quantities of UVA results to skin photosensitivity as well. 

What are the most common types and symptoms sun damage to the skin? These are as follows:

  • Dry skin – the appearance of dry, flaky and prematurely wrinkled than the skin on the other parts of the body that have not been exposed to sunlight. Wrinkling is noted even in younger people. This happens because the skin gradually loses moisture and essential oils due to sun exposure.  Itchiness is common in those with dry skin.
  • Sunburn – this is the common name for the injury to the skin that immediately appears after the skin is exposed to ultraviolet radiation. If the sunburn is mild, there is painful reddening of the skin noted but vesicles or large blisters may be seen in more severe cases. Oftentimes there are clear boundary lines where the skin has been protected from the sun by shirtsleeves, shorts, a bathing suit of other clothing.
  • Actinic keratosis – It is a tiny bump that feels like sandpaper or a persistent small scaly patch of peeling skin, jagged or even sharp surface that has a pink, yellow, red or brownish tint. Actinic keratosis does not disappear, unlike suntan markings or sunburns. It may start as the size of a pimple. Itchiness or tenderness are rarely noted. It has to be removed by a doctor or has to undergo freezing or chemical removal.  There should be a regular follow up with a doctor to periodically check if there are new areas of abnormal skin. This will ensure that the possibility of skin cancer is being monitored.
  • Long-term changes in the skin’s collagen (a structural protein) – These include fine lines, deeper wrinkles, a thickened skin texture and easy bruising over areas exposed to the sun especially the back of the hands and forearm. Photo-aging and actinic purpura are among the changes noted here.  Photo-aging is defined as the premature aging of the skin because of sun exposure. The skin develops wrinkles and fine lines in photo-aging because of changes in the collagen of the dermis which is a deep layer of the skin. In actinic purpura, there is bleeding from fragile vessels underneath the skin surface.

How are these conditions treated?

  • Dry skin - Moisturizers will help a lot.
    • Try using a moisturizer that contains at least one of the following ingredients: glycerin, urea, sorbitol, or lactate salts.  
    • Avoid using alpha-hydroxy acids or other acids on any sunburned skin. 
  • Sunburn – Cool compresses such as applying cool wet cloth to sunburned areas which are painful may alleviate the affected areas with pain.
  • Actinic keratosis – there are several treatment options depending on the number, size, and location of the lesions.
    • Topical fluorouracil
    • Cryotherapy
    • Chemical peels
    • Laser surfacing
    • Shave excision
    • Photodynamic treatment (PDT)
  • Photo-aging and other collagen changes – It is not possible to reverse all the effects of sun damage but the doctor might be able to improve the skin appearance through the following:
    • Direct application of tretinoin or alpha hydroxy acids on the skin
    • Chemical peels
    • Cryosurgery
    • Laser resurfacing
    • Dermabrasion
    • Injection of botulinum toxin
    • Fillers – e.g. Restylane

What should you do in order to avoid having your skin damaged by the sun?

  1. Use sunscreen before going out of the house. 
  2. Use a sunblock on your lips.
  3. Avoid or limit sun exposure between 10 a.m. To 3 p.m. when the sun is at its peak.
  4. Wear sunglasses with UV light protection.
  5. Wear long pants, a shirt with long sleeves and use a wide-brimmed hat.
  6. Some medicine and skin care products can increase the skin’s risk for UV damage.  These include certain antibiotics, prescription medicines to treat psychiatric illness, high blood pressure, heart failure, acne, and allergies.  Skin care products containing alpha-hydroxy acids can make skin vulnerable to damage from sunlight.

It is best to consult a doctor or a dermatologist in case you have questions regarding sun-damaged skin. Remember, it is not only the cosmetic aspect which should worry you. Far more important than appearance is the long- term impact of sun damage with the possibility of developing skin cancer. 

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