Basking in the warm glow of the sun can make us feel good, and in the short term, makes us look good. But the cumulative effects of sun exposure put us at higher risk of cellular damage, early wrinkling, age spots, actinic keratoses, and skin cancer -- including melanoma, the most serious type. Can you spot the effects of excessive sun exposure?
Tanned skin may be revered as beautiful, but that golden color you see is the result of injury to the epidermis, the top layer of skin. Exposure to the sun's ultraviolet (UV) rays accelerates the effects of aging and increases your risk for developing skin cancer. To prevent sun damage, use a sunscreen of SPF 30 or higher when outdoors.
Sunburn (First-Degree Burns)
Sunburn is skin damage from the sun's UV rays. Most sunburns result in redness, heat to the touch, and mild pain, affecting only the outer layer of skin (first degree burns). Sunburn usually appears within hours after sun exposure and may take several days to weeks to fade. Pain relievers such as aspirin or ibuprofen, cold compresses, aloe, or moisturizing creams may help reduce pain and discomfort.
Sunburn (Second Degree)
A second degree burn – damaging deep skin layers and nerve endings -- is usually more painful and takes longer to heal. It's characterized by redness, swelling, and blistering. If blisters form, do not break them -- they're a source of moisture and protection. Breaking the blisters may lead to infection. Consider seeing a doctor if you have a blistered sunburn.
The sun's rays make skin look old and wrinkled years before it should. More than 80% of the signs of skin aging in adults are the result of the tans they had as teens before the age of 18. That's because over time, the sun's ultraviolet light damages the fibers in the skin called elastin. When these fibers breakdown, the skin begins to sag, stretch, and lose its ability to go back into place after stretching.
Uneven Skin Tone
Too much sun also causes irregular coloring or pigmentation of the skin. Some areas of the skin appear darker, while others look lighter. The sun can also cause permanent changes in small blood vessels, giving your skin a reddish appearance.
Flat, pigmented spots on the skin, freckles are usually found on sun-exposed areas of the body. They're more noticeable in the summer, especially among fair-skinned people and those with light or red hair. Freckles pose no health risk. But some cancers in the earliest stages resemble a freckle. See a doctor if the size, shape, or color of a spot changes or becomes painful.
Melasma (Pregnancy Mask)
Melasma (or chloasma) is characterized by tan or brown patches on the cheeks, nose, forehead, and chin. Although usually called the "pregnancy mask," men can also develop it. Melasma may go away after pregnancy. If it persists, melasma can be treated with prescription creams and over-the-counter products. Use a sunscreen at all times if you have melasma, as sunlight worsens the condition.
Age Spots (Solar Lentigines)
These pesky brown or gray spots are not really caused by aging, though they do multiply as you get older. Age spots are the result of sun exposure, which is why they tend to appear on areas that get a lot of sun, such as the face, hands, and chest. Bleaching creams, acid peels, and light-based treatments may lessen their appearance. Solar lentigines are harmless, but to rule out serious skin conditions such as melanoma, see a dermatologist for proper identification.
Actinic Keratosis (Solar Keratosis)
The small, scaly red, brown, or skin-colored patches caused by too much sun exposure commonly occur on the head, neck or hands, but can be found elsewhere on the body. They're the early beginnings of skin cancer. Actinic keratosis usually appears on people after age 40, but they can show up in much younger people. People with fair skin, blond or red hair, and blue or green eyes are most at risk. Early treatment is advised to stop the possible progression to squamous cell carcinoma, a type of skin cancer.
Actinic Cheilitis (Farmer’s Lip)
Related to actinic keratosis, actinic cheilitis is a precancerous condition that usually appears on the lower lips. Scaly patches or persistent dryness and cracking of the lips may be present. Less common symptoms include swelling of the lip, loss of the sharp border between the lip and skin, and prominent lip lines. Actinic cheilitis may eventually evolve into invasive squamous cell carcinoma if not treated.
Squamous Cell Carcinoma
This nonmelanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust, or a sore that doesn't heal. It most often occurs on the nose, forehead, ears, lower lip, hands, and other sun-exposed areas of the body. Squamous cell carcinoma is curable if caught and treated early. If the skin cancer becomes more advanced, treatment will depend on the stage of cancer.
Bowen disease is also called squamous cell carcinoma "in situ." It is a type of skin cancer that is located on surface of the skin. By contrast, "invasive" squamous cell carcinomas have grown inward and spread to the interior of the body. Bowen disease looks like scaly, reddish patches that may be crusted.
Basal Cell Carcinoma
The most common form of skin cancer, basal cell carcinoma is the most easily treatable and least likely to spread, though it can damage surrounding tissue. Because basal cell carcinoma spreads slowly it occurs mostly in adults. Basal cell tumors can take on many forms, including a pearly white or waxy bump, often with visible blood vessels, on the ears, neck, or face. Tumors can also appear as a flat, scaly, flesh-colored or brown patch on the back or chest, or more rarely, a white, waxy scar.
Melanoma is not as common as other types of skin cancer, but it's the most serious and potentially deadly. Possible signs of melanoma include a change in the appearance of a mole or pigmented area. Consult a doctor if a mole changes in size, shape, or color, has irregular edges, is more than one color, is asymmetrical, or itches, oozes, or bleeds. Melanoma can affect the skin only, or it may spread to organs and bones. It can be cured if it's found and treated early.
A cataract is a cloudy area in the lens of the eye that blocks the passage of light to the retina. Cataracts are painless but may cause vision problems, including foggy vision, glare from light, and double vision in one eye. Prevent cataracts by wearing a hat and sunglasses when in the sun.
Shun the Sun
The best way to prevent sunburn, premature wrinkles, skin cancer, and other damaging effects from the sun is to stay out of it, especially between 10 a.m. and 4 p.m., when the sun's rays are strongest. If you can't, apply sunscreen with an SPF of 30 or more liberally (don't forget the lips and ears!), wear a hat and sunglasses, and cover up with clothing when outdoors. If you notice changes to your skin such as a mole changing appearance, a new growth, or a sore that won't heal, see a doctor right way.
American Academy of Dermatology web site. American Cancer Society web site. American Osteopathic College of Dermatology web site. Centers for Disease Control and Prevention web site. Department of Clinical Social Medicine, University of Heidelberg, Germany. DermNet NZ web site. Good Housekeeping web site. Hornung, R. et al. Journal of the American Academy of Dermatology, March 2007. Kaminsky, B and Kaminsky, H. Beyond Botox, Time Warner, 2006. National Cancer Institute web site. National Institutes of Health web site. Skin Cancer Foundation web site. Visual Dx Health web site.
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