Chronic affects of sunlight include photoaging, actinic keratoses Actinic Keratoses Actinic keratoses are precancerous changes in skin cells (keratinocytes) that are a frequent consequence of many years of sun exposure. Diagnosis is clinical. Treatment typically includes lesion-directed... read more , and skin cancer. (See also Overview of Effects of Sunlight Overview of Effects of Sunlight The skin may respond to sunlight with chronic (eg, dermatoheliosis [photoaging], actinic keratosis) or acute (eg, photosensitivity, sunburn) changes. The sun emits a wide range of electromagnetic... read more .)
Chronic exposure to sunlight ages the skin (photoaging, dermatoheliosis, extrinsic aging), primarily by causing destruction of skin collagen due to various biochemical and DNA disruptions. Skin changes include both fine and coarse wrinkles, rough leathery texture, mottled pigmentation, lentigines (large frecklelike spots), sallowness, and telangiectasia.
Actinic keratoses Actinic Keratoses Actinic keratoses are precancerous changes in skin cells (keratinocytes) that are a frequent consequence of many years of sun exposure. Diagnosis is clinical. Treatment typically includes lesion-directed... read more are precancerous changes in skin cells (keratinocytes) that are a frequent consequence of many years of sun exposure. Actinic keratoses may be pink, red, or, less commonly, gray or brown, and may feel rough and scaly.
Seborrheic keratoses Seborrheic Keratoses Seborrheic keratoses are superficial, often pigmented, epithelial lesions that are usually warty but may occur as smooth papules. The cause of seborrheic keratosis is unknown, but genetic mutations... read more look similar to actinic keratoses. They may appear on areas of the skin that are not exposed to sunlight but are not precancerous.
The incidence of squamous cell carcinoma Squamous Cell Carcinoma Squamous cell carcinoma is a malignant tumor of epidermal keratinocytes that invades the dermis; this cancer usually occurs in sun-exposed areas. Local destruction may be extensive, and metastases... read more and basal cell carcinoma Basal Cell Carcinoma Basal cell carcinoma is a superficial, slowly growing papule or nodule that derives from certain epidermal cells. Basal cell carcinomas arise from keratinocytes near the basal layer, which are... read more in fair, light-skinned people is directly proportional to the total annual sunlight in the area. Such lesions are especially common among people who were extensively exposed to sunlight as children and adolescents and among those who are chronically exposed to the sun as part of their profession or recreational activities (eg, athletes, farmers, ranchers, sailors, frequent sunbathers). Sun exposure also substantially increases the risk of malignant melanoma Melanoma Malignant melanoma arises from melanocytes in a pigmented area (eg, skin, mucous membranes, eyes, or central nervous system). Metastasis is correlated with depth of dermal invasion. With spread... read more .
Minimization of UV light exposure
Topical treatments for photoaged skin
Treatment begins with preventive efforts Prevention The skin may respond to sunlight with chronic (eg, dermatoheliosis [photoaging], actinic keratosis) or acute (eg, photosensitivity, sunburn) changes. The sun emits a wide range of electromagnetic... read more to minimize UV light exposure—avoiding the sun and tanning beds and wearing protective clothing and sunscreen.
Various combination therapies, including chemical peels, 5-fluorouracil (5-FU), topical alpha-hydroxy acids, imiquimod, photodynamic therapy, and tretinoin, have been used to reduce precancerous changes and improve the cosmetic appearance of chronically sun-damaged skin. These therapies are often effective in ameliorating superficial skin changes (eg, fine wrinkles, irregular pigmentation, sallowness, roughness, minor laxity) but have a much less pronounced effect on deeper changes (eg, telangiectasias). Many ingredients are used in over-the-counter cosmetic products without significant evidence that they improve chronic changes of the skin caused by sunlight.
Drugs Mentioned In This Article
|Drug Name||Select Trade|
|Adrucil, Carac, Efudex, Fluoroplex, Tolak|
|Altinac, Altreno, Atralin, AVITA, Refissa, Renova, Retin-A, Retin-A Micro, Tretin-X, Vesanoid|