Sun Damage. Everything you need to know

Some of the most conspicuous signs of sun-damaged skin include:

• Sun Freckles: Freckles are small, flat spots of pigmentation that result from overproduction of melanin. They are harmless in most cases, but can be treated with retinoids, 1927nm thulium laser resurfacing, Q switched laser, or laser that targets pigmentation
• Brown Spots: Also known as liver spots, these patches of darkened skin most commonly appear in people over the age of 40. They can be improved with retinoids and our 1927nm thulium fractional resurfacing laser, Q switched laser or Excel V depigmentation
• Seborrhoeic Keratosis: A seborrhoeic keratosis is a benign warty spot can be treated with cryotherapy, shave excision, curettage, diathermy, salicylic acid-based prescription cream and retinoids, 1927 thulium laser or CO2 laser
• Sebaceous Hyperplasia: Sebaceous hyperplasia refers to enlarged oil glands that cause small bumps on the skin and often have a yellow appearance. This common condition can be addressed with diathermy or laser treatment.
• Solar Comedones: Solar comedones are blackheads and whiteheads that are caused by sun exposure. They are not related to acne vulgaris. Solar comedones can be treated with extraction, diathermy, topical retinoids and HydraFacial.
• Solar Keratosis: Solar keratosis or actinic keratosis is a scaly spot that develops on sun-damaged skin. It is considered precancerous and may evolve into squamous cell carcinoma (SCC).

Other indications of sun damage and their treatments include:

• Premature Wrinkles: Fine lines and deeper folds can be treated with laser resurfacing using our fractional CO2 laser, 1927nm thulium laser, radiofrequency (RF) resurfacing, RF peels, or anti-wrinkle injections and dermal fillers (or a combination of these)
• Volume Loss: Reduction of dermal collagen, elastin and subcutaneous fat can be treated with dermal fillers.
• Thickened, Leathery Skin: Thickening of the outermost layer of the skin (epidermis) can be treated with a resurfacing CO2 laser.
• Thin Skin: Skin that is thin and easily damaged can be treated with injection of dermal fillers.
• Easy Bruising: Excessive bruising is challenging to treat. Dermal fillers can help by stimulating collagen production and adding dermal support, respectively, and reducing the tearing of vulnerable blood vessels.
• Skin Laxity: Loose, sagging or crepey skin can be treated with Ultraformer III, Co2 skin resurfacing, RF skin tightening, RF, RF peels, the Venus DiamondPolar device or dermal fillers.
• Facial Telangiectasia: Telangiectasia, the medical term for what are often referred to as broken capillaries, is treated with the vascular laser.
• Poikiloderma of Civatte: These reddish-brown discolourations appear on chronically sun-exposed skin; they are treated with a combination of the laser for redness, laser for pigmentation and skin-lightening cream.
• Diffuse Solar Freckling: This can be treated with a combination of the 1927nm thulium resurfacing laser, prescribed peels, laser for pigmentation and topical retinoids.

Regular evaluations by a dermatologist ensure that precancerous sun spots are treated appropriately and that any skin cancers are identified in a timely fashion. Early diagnosis and treatment of skin cancers are essential.

Medical sun damage refers to solar keratosis. This is a precancerous lesion that develops due to the damage of DNA by UV radiation emitted by the sun. Solar keratoses can present as a scaly patch, a diffuse scaly rash or scaly pigmented changes on the skin. Some solar keratoses are asymptomatic, while others cause skin sensitivity or a stinging sensation.

The presence of one or more solar keratoses means that you are in a higher risk category for developing skin cancers. In some cases, the presence of solar keratosis can mask underlying skin cancers. Treating solar keratoses makes the detection of underlying skin cancers easier and reduces the chance for them to evolve into malignant lesions.

Treatments for solar keratosis fall into two broad categories: spot treatments and field treatments. Spot treatments target specific lesions and are typically best for patients with fewer solar keratoses. Field treatments are used to address a larger number of solar keratoses at once, including those that cannot yet be seen easily or felt.

Spots Treatments:

• Cryotherapy
• Chemotherapy cream containing fluorouracil
• Imiquimod cream

Field Treatments:

• Chemotherapy cream
• Imiquimod cream
• Photodynamic therapy (PDT)
• 1927 thulium resurfacing laser

Laser PDT or laser resurfacing treatment are excellent options for patients who wish to address cosmetic concerns and medical sun damage at the same time.  Please discuss these with your treating dermatologist.

Laser PDT can comprehensively treat solar keratoses, dilated capillaries, brown spots and sebaceous hyperplasia.

Laser resurfacing (with the 1927nm thulium laser and Co2 laser) addresses surface solar keratoses, brown spots and deep wrinkles/lines.

Caring for your skin at home is a critical part of preventing and treating sun damage. Avoid excessive sun exposure, wear protective clothing and hats, and apply sunscreen with SPF 50 daily. Other measures that can help include:

• Applying topical niacinamide (vitamin B3) as part of a serum, sunscreen or moisturiser
• Ingesting niacinamide as an oral supplement
• Using skincare products that contain antioxidants, DNA repair enzymes, retinol and alpha hydroxy acid (AHA)

Book a complimentary appointment with our dermal clinicians to discuss a skincare routine that is appropriate for you.

The dermatologists who consult with us offer the following recommendations for men and women with sun-damaged skin:

• For those with only mild sun damage, a topical retinoid cream and a series of glycolic acid/AHA peels can be helpful. Little downtime is associated with peels.
• For those who can tolerate downtime of 3-6 weeks and who have numerous solar keratoses, chemotherapy cream is the treatment of choice. This is the most cost-effective treatment, and should ideally be undertaken during the cooler months of the year.
• For those who have numerous premalignant sunspots and can only accommodate a downtime of 7 days, PDT is the preferred treatment.  PDT offers a much quicker healing time than chemotherapy cream and can be conducted throughout the year.
• For those who want to address both medical sun damage and cosmetic signs of sun damage including redness and brown spots, laser PDT is the optimal treatment.
• For those with numerous precancerous sunspots, who also want to address concerns such as skin laxity, wrinkling, surface pigment and textural irregularities, then 1927nm thulium resurfacing +/- Co2 laser provides both a resurfacing effect and collagen-stimulating effects.

Different aspects of sun damage need to be treated separately. Book an appointment to discuss your concerns with a consultant dermatologist by calling Northside Dermatology on 03 8582 8688 today.