As we age, our skin undergoes noticeable changes, particularly in areas exposed to the sun’s ultraviolet (UV) radiation. This exposure accelerates aging, a process known as photoaging, and can occur prematurely in individuals who spend considerable time outdoors or experience frequent sunburns, especially those with fair skin.
Photoaging results from a combination of short-wavelength UVB rays affecting the epidermis (outer skin layers) and long-wavelength UVA rays impacting the dermis (middle layers). UV radiation triggers oxidation, ionization, and genetic changes in cellular components, including DNA, weakening the skin’s immune system and increasing the risk of skin cancer.
Repeated inflammation from sunburn, acne, or other skin conditions leads to increased dermal collagen, reducing the dermis’s elasticity. The epidermis thins, causing dryness, blistering, and tearing. The skin becomes weaker and less able to retain moisture.
These aging changes are most evident on the face, manifesting as fine lines, wrinkles, discoloration, and textural changes. Prolonged sun exposure without protection stimulates melanocytes, leading to uneven pigmentation, brown freckles, solar lentigines, and white spots.
Damaged elastin protein accumulates in the dermis, forming yellow, thickened bumps (elastosis or heliosis). Aging skin is also susceptible to brown, warty lesions (seborrheic keratoses), cherry-red spots (angiomas), dilated blood vessels (telangiectases), and bruises (senile purpura).
Tender, red, dry spots, known as solar keratoses or actinic keratoses, commonly appear on the backs of hands but can also develop on the temples, nose, cheeks, and upper lip.
Dermatologists classify photoaging severity into stages: Mild (28-35 years) with few wrinkles and no keratoses; Moderate (35-50 years) with early wrinkling and actinic keratoses; Advanced (50-60 years) with persistent wrinkling, discoloration, and actinic keratoses; and Severe (65-70 years) with severe wrinkling, gravitational and dynamic forces affecting the skin, and actinic keratoses, potentially with skin cancer.
To mitigate or delay further damage, protect sun-damaged skin from further sun exposure. Avoid outdoor activities during peak sunlight hours, especially in summer. Use sunscreen daily, reapplying frequently when outdoors.
A variety of cosmetic products, from moisturizers and sunscreens to retinoid creams and alpha-hydroxy acids, are available for aging skin. Consult a dermatologist or plastic surgeon for expert advice. Cosmetic surgeons may recommend clinical treatments like BOTOX® Cosmetic or resurfacing procedures such as dermabrasion, chemical peels, and laser resurfacing to rejuvenate photoaged skin. Surgical interventions, such as blepharoplasty for baggy eyelids or a facelift for tightening jowls, can address redundant, sagging skin.