To many, the sun is a symbol of warmth, relaxation and happy holiday times. A tan was traditionally regarded as a sign of wealth, the ability to afford travel to faraway places for basking in the sun.
We do need sunlight to synthesise the vitamin D in our skin, but two to eight minutes outside on a sunny day for light-skinned individuals is enough for maximum production. We can also supplement this with dietary intake of vitamin D.
On the negative side, the sun is the main cause of skin aging and skin cancer. It affects the skin at all levels:
1. It decreases the turnover of skin cells, making the skin thinner.
2. It affects the maturation of skin cells, resulting in skin roughness and precursors of skin cancer called actinic keratosis.
3. It dysregulates melanin pigment synthesis and distribution, leading to freckling, melasma and other pigment abnormalities.
4. It decreases collagen (connective tissue) synthesis and increases the breakdown of collagen, resulting in fine lines and wrinkles.
5. It causes an accumulation of non-functional elastins leading to a loss of skin elasticity and firmness and the development of dilated blood vessels.
Therefore, the most important anti-aging modality is sun avoidance and sun protection, ie hats, clothing and sunscreen preparations. In Cape Town, the sun reaches its maximum intensity closer to 1 pm than 12 noon. If possible, one should therefore avoid exposure between 10 am and 4 pm, especially in summer on sunny days.
Sunscreen preparations should be applied to sun-exposed areas every day of the year, even on rainy days. Electromagnetic radiation emitted by the sun includes ultra-violet (5%), visible (50%) and infrared radiation (45%), and all three can cause skin aging and skin cancer.
One doesn’t have to be sunburnt to be negatively affected by the sun. As some sunscreens mainly protect against sunburn (UVB), they give one a false sense of security as the sun’s aging effect continues relentlessly. Thankfully, there are sunscreen preparations with broad spectrum efficacy, some even with enzymes that help reverse the damaging effects of the sun on the DNA of skin cells.
At our clinics, Lasermed in Tyger Valley and Derma Therapeutics in Wynberg, we provide several cosmeceutical and therapeutic modalities to help prevent and reverse the negative effects of the sun, emphasising sun avoidance and sun protection. We provide effective sunscreens and advise on their correct use, appropriate amounts and reapplication frequency. We screen for signs of photo-aging, precursors of skin cancer and true skin cancer (basal cell carcinoma, squamous cell carcinoma and malignant melanoma) and treat them appropriately.
Treatment modalities at our clinics include:
• Anti-oxidant preparations to counter the damaging effect of free radicals resulting from sun exposure
• Growth factors for skin rejuvenations
• Cryotherapy to treat skin cancer precursors
• Topical preparations – correct pigmentation abnormalities and restore even tone
• Medical peels – correct pigment abnormalities and rejuvenate photo-aged skin
• Medical microneedling – stimulate collagen production and promote rejuvenation
• Microdermabrasion – improve skin texture
• Botox for dynamic wrinkles such as frown lines, crow’s feet and frontal lines
• Hyaluronic acid fillers for static wrinkles
• Surgery for skin cancers
The sun is thus both friend and foe. Without it, we wouldn’t exist, but, it needs to be treated with respect as too much exposure results in sunburn, skin aging and skin cancer.
Dr Jonathan Smith is a dermatologist. Tel: 9147676.
