The Skin Cancer Foundation Journal

MAY 2014

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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20 1 S K I N C A N C E R F O U N D A T I O N J O U R N A L T o assess photoaging, dermatologists use a "black" light or a camera equipped with an ultraviolet flter. When the device's long wavelength of ultraviolet light shines deeply into the skin, sun damage that is often hidden under the surface of seemingly "perfect" skin appears as heavy, all-over freckling with clumps of dark pigment. As such damage progresses over your lifetime, the signs of aging become more and more visible, such as dullness, freckles, blotches, fne wrinkling, and dilated and broken blood vessels. Deep wrinkling, a leathery texture, and skin cancers are the ultimate result of photodamage. All skin types are susceptible to this damage, but darker skin takes longer to photoage because its greater melanin (pigment) content ofers a limited amount of sun protection. If you have indulged yourself in sunbathing or unprotected sun exposure up to this point, stop now! My advice is to re- nounce sunbathing and tanning salons forever. If you believe you look better with a tan, numerous makeups, bronzers, and self-tanners can give you the same sun-kissed glow without contributing to the natural aging process or to skin cancer. Can anything be done to reverse photodamage? Y es, the good news is that several ways exist to help reverse the damage. Many treatment options, including topical agents, lasers, chemical peels, injectable fllers, and neuromodulating agents (such as Botox ® ) can be used to target diferent features of photoaged skin. In my experi- ence, combination therapy that incorporates several such methods helps patients derive the greatest beneft. 2,3,4,5 Every aspect of a photoaging treatment program starts and ends with sun protection, including a broad spec- trum sunscreen with a Sun Protection Factor (SPF) of 30 or higher. The ingredients in skincare products that are especially helpful in reversing photodamage include retinoids (e.g., prescription strength tretinoin, Retin-A ® , or retinol), al- phahydroxy acids (e.g., glycolic acid or lactic acid), be- tahydroxy acids, bleaching agents (e.g., hydroquinone, kojic acid or arbutin), antioxidants (e.g., vitamins A, C, and E), hyaluronic acid fllers, and peptides. 5 One look is worth 1,000 words The following cases illustrate ways that com- bination therapy can reverse photoaging: Deep wrinkling, a leathery texture, and skin cancers are the ultimate result of photoaging. Beauty & Anti-Aging CASE #1: PHOTOAGING OF THE HANDS CAUSING "AGE SPOTS" A 71-year-old white female was self-conscious about the "age spots" on her hands [left]. A Q -switched alexandrite laser, which emits very short fashes of light called "pulses" to disperse pigment within the skin, was used during a single 20-minute session to "zap" each age spot, causing the area to crust ("scab"). Three weeks later, the crusts have fallen of, the skin is uniform in color, and the age spots have disap- peared [right]. She must be diligent in daily use of sunscreen to prevent pho- todamage in the future, remembering to apply it to the tops of her hands.

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