By Lisa Chipps, MD, MS, FAAD
Lisa Chipps, MD, MS, FAAD, is a dermatologist and cosmetic surgeon specializing in Mohs micrographic skin cancer surgery. Dr. Chipps is board certified by the American Board of Dermatology and a Diplomate of the American Board of Cosmetic Surgery. She practices in Southern California at Moy-Fincher-Chipps Facial Plastics/Dermatology and is on staff at Harbor-UCLA Medical Center and Cedars-Sinai Medical Center in Los Angeles. She was featured in Los Angeles Magazine’s Best of LA 2013 edition as a Super Doctor Southern California Rising Star.
Q: If I’ve suffered ultraviolet damage in the past from sunburns and indoor tanning, is it too late to prevent skin cancer and premature aging, or are there ways to minimize my risk? Can I repair or even reverse much of the damage by practicing sun-safe behavior from now on and staying out of tanning beds?
A: The truth is, the skin has a long memory. The damage from all the tans and sunburns you experience is more or less permanently recorded in it, and this ultraviolet (UV) damage is cumulative throughout your life. It can lead to wrinkles, brown spots, and other signs of early skin aging, as well as precancerous skin lesions and cancers. It may take years or decades for the effects to catch up with us, but when they do, our appearance suffers and skin cancers may start to show up.
However, by taking better care of your skin from now on, you may be able to stave off skin cancers and minimize skin aging.
Here’s how: Start sun-safe practices now, and never stop. That’s the first step in any skin repair program. It will prevent more UV damage from accumulating and give your skin some chance to heal from past damage.
Limiting your UV exposure is the key. Choose early mornings or late afternoons for outdoor activities, when the sun is less intense. Seek shaded areas whenever possible, or bring your own shade, such as a large umbrella. In the sun, wear broad-brimmed hats, UV-filtering sunglasses, long sleeves and other sun-protective clothing. Also, stay out of tanning beds, which can produce even more concentrated UV exposure than the sun.
Use broad spectrum sunscreen DAILY on ALL exposed skin. No one can stay in the shade all the time outdoors, and if you’re swimming, even more of your skin is exposed. Furthermore, your face is always exposed. So every day, use a broad spectrum sunscreen that protects against both UVA and UVB rays, ideally with an SPF (Sun Protection Factor) of at least 30 for extended stays outdoors. The best product is one you will actually use, so choose a sunscreen whose scent and feel you like, whether cream, lotion, powder or spray. Reapply at least every two hours, and immediately after swimming or exercising.
Repair your damaged DNA. Skin cells are equipped with natural repair enzymes to help fix sun-damaged DNA, but with age these repair mechanisms weaken. Replace them with products containing DNA repair enzymes. These can help heal recent sun damage before it becomes permanent, and eliminate precancerous cells that could ultimately lead to cancers.
Consider a retinoid. Topical retinoids, which are vitamin A derivatives such as prescription tretinoin, can help your skin shed damaged skin layers and rebuild damaged collagen in the dermis. Your dermatologist can prescribe the right product for your skin. Note, however, that topical tretinoin may increase photosensitivity, so when using it, practice sun protection scrupulously.
Try a laser. Laser treatments can remove sun-damaged cells and stimulate collagen production to improve the appearance of mottled or rough, leathery skin. Some lasers can treat precancerous lesions, reducing your risk of developing skin cancer. Your dermatologist can advise you on which, if any, laser treatment might be best for you.