Tuesday, 28 April 2020 13:18

Sun Damage: Understanding sun care in relation to acne, aging, and cancer

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After enduring the long gray cast of winter, there is no question that feeling the suns warm embrace on bare skin induces a therapeutic pleasure response. It makes sense scientifically, since the bodys ability to produce serotonin, also known as the happy hormone, is directly affected by sunlight. Lack of sunlight can actually lead to a condition known as seasonal affective disorder, in which patients individualsdisplay symptoms of depression associated with a drop in serotonin levels experienced during months with reduced sunlight.

 

However, despite the feelings of well-being sunlight exudes, indulging in it has a dark side. Exposure to ultraviolet rays accounts for a staggering 80% to 90% of the visible effects of aging. The sun emits two basic types of ultraviolet rays that reach skin: long-wave UVA and short-wave UVB. Both wavelengths create free radicals that impair cellular function, altering genetic material, and damaging the collagen and elastin fibers found within the skin. Accounting for 95% of the ultraviolet light that reaches skin, UVA rays penetrate far beyond the dermis, wreaking havoc on each layer of the skin, and is responsible for wrinkles and visible aging. UVA rays are also a major contributor to skin cancers. UVB rays are shorter waves, directly responsible for sunburns, which can lead to skin cancers later in life. When choosing a sun protection factor sunscreen, it is important to select a product that offers both UVA and UVB broad-spectrum coverage to ensure adequate protection.

BREAKING DOWN SPF 

When choosing a sunscreen, look for a broad-spectrum UVA and UVB formula with a sun protection factor of 30 or above. SPF (sun protection factor) denotes the amount of time skin is protected. Multiply the SPF by the amount of time it takes skin to burn without protection, and this will give the amount of time in minutes the sunscreen will protect skin. Keep in mind that a SPF of 30 blocks out 97% of UVB rays, so as the sun protection factor increases, the amount of increased protection is negligible. Be sure to apply sunscreen at least 20 minutes before sun exposure and reapply every two hours or more often if sweating or swimming.

CHEMICAL OR PHYSICAL 

With so many formulations available to clients, there are sunscreen options for every skin type and preference. The key to selecting the right product is understanding how each works and which will better suit a client’s needs.

Chemical Sunscreen 

What differentiates physical from chemical sunscreens are the ingredients found in each and the way they offer protection. Chemical sunscreens are comprised of active ingredients which are non-natural, chemical compounds and work by absorbing the suns ultraviolet rays by way of a chemical reaction that transforms ultraviolet rays into heat. Ultraviolet rays are then forced to dissipate and the skin is protected. Since skin absorbs chemical sunscreens, trace amounts might seep into the bloodstream, presenting an opportunity for irritation, discomfort, or allergic reactions. After applying chemical sunscreens, wait at least 20 minutes before sun exposure to ensure maximum effectiveness.Common ingredients found in chemical sunscreens includeoxybenzone octisalateavobenzone octocrylene, and octinoxate homosalate.

Physical Sunscreens 

In contrast to chemical sunscreens which penetrate the skin, physical or mineral sunscreens work by providing a physical barrier between the suns rays and the skin. Physical sunscreens offer sun protection at the moment of application and are less likely to clog pores. Damaging ultraviolet rays are deflected and scattered away from the skin. The most common ingredients in physical sunscreens are titanium dioxide and zinc oxide, with zinc oxide offering slightly better coverage against UVA and UVB rays. Zinc oxide is also antimicrobial and noncomedogenic, making it ideal for acneic skin. Also noncomedogenic and gentle on the skin, titanium dioxide is a natural mineral used as a thickening, whitening, and lubricating agent in sunscreens and cosmetics. Titanium dioxide is a great choice for sensitive skin that is prone to redness; however,it is better suited for casual sun exposure since its ultraviolet absorption spectrum is not as broad as zinc oxide.

 

While dry skin will benefit from using a daily moisturizer that incorporates sunscreen, those with oily or combination skin should select light creams, fluids, or gels labeled noncomedogenic to avoid excess clogging of pores. Oil-free products provide a non-greasy finish without contributing excess shine to the complexion. Those with sensitive or sensitized skin should opt for fragrance-free, hypoallergenic formulas to minimize the chance of irritation. Lightweight and long-wearing, chemical-free, mineral sunscreens are well-tolerated by sensitive skin types.

SUN PROTECTION AND ACNE 

A common misconception touting the benefits of sunlight is the belief that basking in the sun will effectively remedy a bout of acne. While blemishes appear to diminish following sun exposure, the effect is as misleading as it is fleeting. In response to sunlight, the body dispatches melanin, which gives the skin its color, to absorb ultraviolet light and protect the skin from further damage. While this bronzing effect temporarilymasks redness associated with acne, the potential damage being caused by exposure to the suns rays far outweighs its short-lived benefits. The underlying causes of the acne breakouts should rather be addressed and paired with the appropriate treatment and sun protection to maintain a smooth, healthy complexion.

 

In fact, too much exposure to the suns rays can actually worsen acne by exacerbating dryness due to the overstimulation of the sebaceous glands. This leads to an excess of sebum production, referred to as seborrhea, and the formation of blemishes. Excessive drying of surface skin cells can cause them to harden, a response is known as keratinization. This process interferes with the skins natural shedding process, preventing the release of sebum out of the pores and resulting in the formation of comedones. Cumulative sun damage also leads to an inconsistency in the thicknessof various areas of the skin. This can result in the emergence of acne lesions as sebum and P.acnes bacteria combine with dead skin cells to clog pores due to the improper sloughing of these excess layers of skin. Not only does ultraviolet radiation cause an increase in inflammation and redness in the skin, the potential for discoloration(especially in clients suffering from acne marks,) is heightened. Post-inflammatory hyperpigmentation is a bothersome condition which can persist for months or even years.

 

It is especially important to be diligent with sun protection when using oral or topical acne medications, as certain active ingredients can heighten skin sensitivity to UVA and UVB rays. These medications can cause excessive drying of the sebaceous glands, depleting the skin’s natural moisture barrier and triggering a rapid rate of cell growth and exfoliation. This process leaves the skin exposed and more vulnerable to the damaging effects of ultraviolet rays. Some of the more common ingredients used in the treatment of acne include glycolic acid, retinoids, salicylic acid, and benzoyl peroxide. Isotretinoin and doxycycline are more aggressive forms of acne management that have the propensity to cause rapid sunburn and should be taken with extreme caution and diligent sun protection.

 

A safe alternative for treating mild to moderate acne breakouts that is easy to use and backed by scientific research is phototherapy. The light emitted by these devices does not generate the same cancer-causing wavelengths as the suns rays. FDA-approved for acne, blue light therapy works by penetrating deep into the pores to kill the bacteria P.acnes on the skin. Red light can penetrate deep into the skin to activate hemoglobin, cutting off the blood supply of sebaceous glands, so the pores arenot able to secrete as much sebum. The best results can be seen when red and blue light are used together.

 

When used consistently, sun protection can help to prevent, slow down, or even reverse the signs of sun damage. It is important to avoid the peak hours of sun exposure between the hours of 10 A.M.to P.M. when the suns rays are strongest. Opt for tightly woven, loose-fitting clothing, a broad-brimmed hat, and sunglasses that offer UVA and UVB protection. Be diligent about wearing sunscreen every day of the year, including cloudy days.

BREAKING DOWN SUN PROTECTION FACTOR 

When choosing a sunscreen, look for a broad-spectrum UVA and UVB formula with a sun protection factor of 30 or above. Sun protection factor denotes the amount of time skin is protected. Multiply the sun protection factor by the amount of time it takes skin to burn without protection, and this will give the amount of time in minutes the sunscreen will protect skin. Keep in mind that a sun protection factor of 30 blocks out 97% of UVB rays, so as the sun protection factor increases, the amount of increased protection is negligible. Be sure to apply sunscreen at least 20 minutes before sun exposure, and reapply every two hours or more often if sweating or swimming.

 

With so many formulations available to clients, there are sunscreen options for every skin type and preference. The key to selecting the right product is understanding how each works and which will better suit a client’s needs.

Chemical Sunscreen 

What differentiates physical from chemical sunscreens are the ingredients found in each and the manner in which they offer protection. Chemical sunscreens are comprised of active ingredients which are non-natural, chemical compounds, and work by absorbing the suns ultraviolet rays by way of a chemical reaction that transforms ultraviolet rays into heat. Ultraviolet rays are then forced to dissipate and the skin is protected. Since skin absorbs chemical sunscreens, trace amounts might seep into the bloodstream, presenting an opportunity for irritation, discomfort, or allergic reactions. After applying chemical sunscreens, wait at least 20 minutes before sun exposure to ensure maximum effectiveness.Common ingredients found in chemical sunscreens includeoxybenzone octisalateavobenzone octocrylene, andoctinoxate homosalate.

Physical Sunscreens 

In contrast to chemical sunscreens which penetrate the skin, physical or mineral sunscreens work by providing a physical barrier between the suns rays and the skin. Mineral sunscreens offer sun protection at the moment of application and are less likely to clog pores. Damaging ultraviolet rays are deflected and scattered away from the skin. The most common ingredients in mineral sunscreens are titanium dioxide and zinc oxide, with zinc oxide offering slightly better coverage against UVA and UVB rays. Zinc oxide is also antimicrobial and non-comedogenic, making it ideal for acneic skin. Also, non-comedogenic and gentle on the skin, titanium dioxide is a natural mineral used as a thickening, whitening, and lubricating agent in sunscreens and cosmetics. Titanium dioxide is a great choice for sensitive skin that is prone to redness; however, it is better suited for casual sun exposure since its ultraviolet absorption spectrum is not as broad as zinc oxide.

 

While dry skin will benefit from using a daily moisturizer that incorporates sun protection factor, those with oily or combination skin should select light creams, fluids, or gels labeled non-comedogenic to avoid excess clogging of pores. Oil-free products provide a non-greasy finish without contributing excess shine to the complexion. Those with sensitive or sensitized skin should opt for fragrance-free, hypoallergenic formulas to minimize the chance of irritation. Lightweight and long-wearing, chemical-free, mineral sunscreens are well-tolerated by sensitive skin types.

 

While wearing sunscreen regularly will provide ample prevention from future injury to the skin from exposure to ultraviolet light, learning to identify and promptly treat present sun damage can turn back the hands of time and provide an opportunity to detect malformations of the skin that could possibly lead to skin cancerCommon signs of sun damage includeskin discoloration and hyperpigmentation,loss of elasticity and droopingbroken capillaries and spider veins,fine lines and wrinkles, and atypical moles, reddish-brown patchesand raised scaly growths. Other signs of sun damage can includethinner, more translucent skin,loose, sagging skin on the neck area resulting from a breakdown in collagen,broken capillaries,dry, rough, leathery skin,large freckles, age spots or liver spots,blotchy or ruddy complexion,and chronically chapped, dry lips due to sun exposureas lips are often overlooked when applying sun protection factor but are just as prone to sunburn.

 

Always consult a Dermatologist to diagnose, monitor, and rule out skin cancers.

SUN CARE AND AGING 

There is a multitude of ways to treat the various signs of existing sun damage. Fine lines and wrinkles can be minimized by implementing a daily regimen of results-driven correctives and serums which contain age-fighting ingredients such as vitamin C, which work to repair existing damage and neutralize free radicals; prescription retinoids which stimulate collagen production; and alpha hydroxy acids for increased cellular turnover. For deep-set wrinkles, injectable fillers can provide an instant plumping and smoothing effect, while the injection of neurotoxins can be utilized to minimize the movement and depth of expression lines.

 

Age spots, discoloration, and hyperpigmentation can be addressed through the use of skin-lightening ingredients such as kojic acid, glycolic and lactic acids, arbutin, niacinamide, and azelaic acid, as well as stronger, prescription topicals such as hydroquinone and corticosteroids. A series of chemical peels which toremove the topmost layer of skin to reveal new, smoother skin is beneficial for a host of skin concerns. In order to prevent recurrent hyperpigmentation or discoloration triggered by this procedure, it is important to prime the skin using depigmenting agents, such as hydroquinone, beforehand. Laser and intense pulsed light therapies work by destroying melanocytes which thatproduce melanin without damaging the skins surface. For isolated spots, cryotherapy may prove beneficial at precisely lightening a specific small area. Intensive fractional resurfacing treatments can improve tone and texture by stimulating the growth of healthy new tissue by delivering microbeams of light into the lower layers of skin, which creates deep, narrow columns of tissue coagulation. This procedure is ideal for the face, neck, chest, and arms and is an excellent choice for correcting a multitude of sun damage, including fine lines and wrinkles, sagging skin, hyperpigmentation, and age spots.

 

When applying sunscreen, always be mindful to extend the application down the neck and across the décolleté. The skin on the neck is much more delicate and thinner than the skin on the face and has few oil-producing glands, making it more susceptible to visible aging. Over time and with continued exposure to the suns rays, the neck can develop irregular pigmentation, looseness, sagging, and broken capillaries. A combination of hydrating topicals, prescription retinoids, growth factors, and peptides are beneficial in the treatment of loose skin; however, more impressive results can be achieved through the use of non-invasive radio frequency, ultrasound, and intense pulsed light treatments to combat loose skin and stimulate collagen and elastin production.

 

SIGNS OF SUN DAMAGE 

While wearing sunscreen regularly will provide ample prevention from future injury to the skin from exposure to ultraviolet light, learning to identify and promptly treat present sun damage can turn back the hands of time and provide an opportunity to detect malformations of the skin that could possibly lead to skin cancerCommon signs of sun damage includeskin discoloration and hyperpigmentationloss of elasticity and droopingbroken capillaries and spider veinsfine lines and wrinkles; and atypical moles, reddish-brown patches, and raised, scaly growths. Other signs of sun damage can include thinner, more translucent skinloose, sagging skin on the neck area resulting from a breakdown in collagenbroken capillariesdry, rough, leathery skinlarge freckles, age spots or liver spotsblotchy or ruddy complexion; and chronically chapped, dry lips due to sun exposure, as lips are often overlooked when applying sunscreen but are just as prone to sunburn.

 

Always consult a dermatologist to diagnose, monitor, and rule out skin cancers.

SKIN CANCER 

The most alarming form of sun damage resulting from overexposure to sunlight are skin cancers. Skin cancer is an uncontrolled growth of abnormal skin cells, which can result in tumors that may be malignant or benign. There are three types of skin cancers, and it is imperative that professionals familiarize themselves with the characteristics of each to be able to serve as the clients first line of defense in identifying possible cancers and precancerous lesions.

 

Basal cell carcinoma is a skin cancer that originates in the basal cells, which make up the outermost layer of the skin and are thought to be caused by long-term exposure to ultraviolet light. While commonly occurring on parts of the body exposed to the sun, basal cell carcinomas can develop anywhere. These can appear as a translucent, pearly white, or flesh-colored bump, often seen on the face and ears or as darker lesions with slightly raised, translucent borders. Basal cell carcinomas can also appear as flat and red scaly patches or white, waxy lesions with no clearly defined borders. Encouraging regular skin checks will ensure clients become familiar with their skin, so they will recognize any unusual or changing areas that require further examination.

 

Squamous cell carcinoma is a common type of skin cancer, often resulting from prolonged exposure to ultraviolet radiation from sunlight or commercial tanning beds. This type of slow-growing cancer develops in the squamous cells that comprise the middle and outer layers of the skin and, if left untreated, can spread to the tissue, lymph nodes, and bones. A red, scaly sore or scab that does not heal in a reasonable amount of time or an unusual flat patch of rough skin should be examined by a physician to rule out the possibility of skin cancer. 

 

Melanoma, the deadliest form of skin cancer, develops when DNA damage from sun exposure to skin cells triggers mutations, leading to rapid multiplication of skin cells that form malignant tumors. Melanoma can occur on any part of the body, developing from exposure to ultraviolet rays from sunlight, tanning lamps, or even resulting from intense sun exposure or sunburns occurring in early childhood. Early detection is vital in preventing the spread of this aggressive cancer.

 

While there is a solution or modality to remedy every form of sun damage, the best prescription is sun prevention. Implementation of a results-driven skin care regimen that addresses skin concerns should be complemented with a daily, broad-spectrum coverage sunscreen to not only protect the skin,but prevent the introduction of future damage or compounding current sun damage. There is little room needed for evidence substantiating the suns detrimental effects on the health of the skin. Help clients aim for consistency in making sun protection a daily affair andremind them to schedule an annual checkup with a professional to note and monitor changes in the skin since early detection could be monumental.

 

 

Suzanne Whigham 2019

 

 

 

A graduate of Aveda Institute of Lafayette, Suzanne Whigham has served as a licensed aesthetician for nine years with extensive training in various treatment modalities and techniques. She especially enjoys educating others through in-depth consultation, encouraging a whole mind-body approach to skin care. 

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May 2021

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