Published on August 2, 2006
There are many treatments available to combat the aging effects of the sun, from creams to peels to lasers. Plus, reducing the signs of sun damage can reduce your risk of developing skin cancer.
The sun and the years take their toll on your skin. Photoaging is often the first sign that your skin has been damaged, but such repeated exposure can also lead to skin cancer. Luckily, many of the treatments for photoaging not only restore skin's youthful appearance, they also reduce your risk for developing skin cancers and precancers.
If you don't wear a sunscreen every day, today is the day to start. Daily application of sunscreen with an SPF of 15 or higher- whether on its own, or in a moisturizer - will prevent additional damage to your skin. Also, studies have shown that daily use of sunscreen can actually reduce the existing number of actinic keratoses - abnormal skin eruptions, or precancers, that can lead to skin cancer.
Retinoids have been a breakthrough discovery for the treatment of photoaged skin. Synthetic derivatives of Vitamin A, they can improve discoloration of the skin, degeneration of elastic tissue, and fine wrinkling by enhancing naturally occurring production of collagen and elastic fibers. In addition to giving skin back its youthful appearance, retinoids can inhibit tumor growth, decrease inflammation, and enhance the immune system. Continuing use of retinoids can reduce the number and size of actinic keratoses. Currently, two retinoids are available in the US for treatment of photoaging: tretinoin (2) and tazarotene. Note that retinoids can irritate the skin and cause dryness and photosensitivity - an extreme sensitivity to the sun. They are available by prescription only.
Lasers are used to vaporize the skin's sun-damaged top layer, leaving a softer, smoother skin surface with less pronounced wrinkles. With their pinpoint accuracy, lasers are ideal for sensitive skin areas such as around the eyes. The treatment can result in tenderness, scarring, redness and swelling that can last for several weeks while the new skin grows. Darker-skinned individuals can experience permanent loss of pigmentation.
Lasers can be used for treatment of actinic keratoses, as well.
A new technology called IPL (intense pulsed light) is a non-skin-removing technique ("non-ablative") that offers patients a softening of lines and shallow wrinkles, fading of some scars, removal of broken capillaries, and stimulation of new collagen growth quickly. After-effects can include swelling, redness, blotchiness, and darkening of pigmented areas. Usually several sessions are needed for optimal results, and the full effects of the treatments may not be visible for up to six months after the final treatment.
Chemical peels are often used to rejuvenate the skin, reduce wrinkles, and treat actinic keratoses. A doctor removes layers of skin with a mild acid solution. Depending on the damage, a light, medium, or deep peel is used. After the skin heals, a smoother, younger-looking outer layer forms. Light peels usually result in only a slight redness and photosensitivity, but deeper peels can result in significant swelling, redness, and photosensitivity that lasts for several weeks.
Dermabrasion uses a small high-speed, rotating metal brush or file to abrade the upper layers of the skin and smooth out surface irregularities. It is used, often with long-lasting results, for treatment of substantial wrinkling and leathering from the sun, pigmentation problems, and acne scars. Either local or general anesthetic is used during the procedure. Redness, swelling and pain are typical after treatment. Healing can take from 7 to 14 days.
For mild to moderate photoaging, a variation of the technique known as microdermabrasion uses tiny particles that pass through a vacuum tube to gently scrape away aging skin and stimulate new cell growth. Mild redness is typically the only side effect.
Almost 20 years have passed since the first injections of botulinum toxin A were done for frown lines between the eyebrows. Since then, it has become one of the most popular cosmetic procedures in the US. When skin loses its elasticity, facial wrinkles develop and form lines - like the pleats of an accordion. Botox works by weakening or temporarily paralyzing the muscles and smoothing the wrinkle away.
Botox is currently approved by the FDA only for the frown lines between the eyebrows. However, it is used "off-label" (without FDA approval) for horizontal forehead lines, crow's feet around the eyes, vertical lip lines and neck banding. Side effects are usually mild to moderate, and can include bruising around the injection area, headache and muscle weakness. Botox does not reduce the incidence of skin cancer. It is a cosmetic procedure only.
Filling substances are injected under facial skin to round out contours and correct wrinkles, furrows and hollows. A number of substances are currently used in the US as fillers, including bovine collagen, polymer implants, and the patient's own (autologous) fat. To maintain the effects of bovine collagen and autologous fat, the procedure needs to be repeated periodically. Some patients are allergic to fillers, and a dermatologist should perform an allergy test before treatment. Side effects can include redness, swelling, bruising, and moderate pain, depending on the type of filler used.
Many of these treatments can be used in conjunction with one another to produce younger-looking skin and reduce the risk of skin cancer. It is important to consult with a licensed dermatologist to discuss treatment options, as many of these treatments can cause damage in inexperienced hands.