You might not be overly concerned about your appearance. But here’s a sobering thought. Your wrinkles and sun spots may be reflect more than just your age, they may reflect your exposure to the sun. And this is a matter for concern, as it could be a manifestation of photoageing.

The word photoageing refers to premature ageing of the skin caused by radiation from ultraviolet (UV) rays (or light, that is, phos in Greek, which is the root of photo, and hence the name photoageing). Most of our UV exposure comes from the sun. In fact, the Canadian Dermatology Association attributes 90 per cent of skin ageing to the harmful effects of sun exposure. Artificial UV sources include tanning booths, mercury vapour lamps, and halogen lights.

Signs of photoageing include wrinkles around the eyes, mouth, and forehead; spider veins on the face and neck; paler and thinner lips; frown lines that are visible even when you are not frowning; leathery and loose skin; age or liver spots (solar lentigines in medical terminology); easy bruising of skin; and red and scaly spots (referred to as actinic keratoses).

Our skin has three layers: the epidermis which is the outermost, the dermis which is the next, and the subcutis which is the deepest. UV rays, specifically UVA rays make their way through the epidermis and into the dermis. Here, they damage collagen, one of the fibres responsible for skin structure. Our body is not entirely helpless, so it deploys enzymes that help rebuild this collagen.

However, repeated exposure and damage could cause the enzymes to malfunction. This would lead to incorrectly rebuilt skin, which eventually appears as wrinkles and leathery skin. Similarly, age or liver spots are the result of a congregation of melanocytes on a particular patch of skin. Melanocytes are the cells that create melanin, which gives our skin its colour. Reacting to excessive sun exposure, melanocytes proliferate in a particular location. For instance, among men, liver spots are usually found on the hands, arms, face, and back, which are more exposed to the sun than other parts of the body.

What makes photoageing dangerous is the fact that any one of its symptoms could be an indicator of skin cancer. Actinic keratoses are particularly dangerous. These usually red, scaly or crusty, rough growths that appear on sun-exposed skin could, if left untreated, morph into squamous cell carcinoma (SCC), one of the three most common types of skin cancer.

Photoageing is very easy to guard against. Avoid tanning booths, for one and limit sun exposure. The harmful UVA rays are at their strongest from 11am to 3pm. So, it is best to avoid stepping out into the sun during this time.

If you cannot do this, remember not to leave home without adequate protection for your skin. Doctors recommend liberal use of sunscreen that has a sun-protection factor (SPF) of 30 or higher and offers broad spectrum protection from UVA and UVB rays. Ensure that all exposed skin is treated with sunscreen. If possible, wear sunglasses that offer UV protection, long-sleeved clothes, and a wide-brimmed hat (or carry an umbrella).

Much has been written about our need for Vitamin D and how the sun is the best source for it According to doctors, lighter-skinned people need only a few minutes of sun exposure per day to meet their quota of Vitamin D, while darker-skinned or Asian people would need 20 minutes.

Remember that lighter-skinned people with lesser melanin in their skin are more at risk of photoageing than darker-skinned individuals.

However, all is not lost if you think you have developed symptoms of photoageing. The first step is a comprehensive self-examination to detect such signs. Then, consult a doctor, ideally a dermatologist, to ascertain if any of these are causes for concern. If you are light-skinned, have a history of sunburn, have relatives who suffer from melanoma (another common type of skin cancer), then doctors advise regular self-examinations to detect skin abnormalities and annual medical examinations to determine if you are at risk of skin cancer.

If your doctor finds evidence of photoageing, he or she will recommend an appropriate course of treatment. Photoageing treatments are also anti-ageing treatments, including those that we have all heard about at some time — botox and fillers. Laser, chemical peels, and the administration of retinoids (synthetic derivatives of Vitamin A) are some other popular treatments prescribed for photoageing. In fact, recent studies have found that some treatments for photoageing, such as chemical peel, laser and retinoid, could prevent skin cancer as well. However, this is not true for all treatments. Botox, for instance, is merely a cosmetic treatment.

Given the link between photoageing and cancer, it is important to take treatment advice seriously. It is foolish to dismiss the signs of photoageing as part of the natural process of growing old. You could opt to avoid anti-ageing treatments if your situation is not considered medically threatening but to ensure that it isn’t, consult your dermatologist at the earliest.

DR SAROJ SUVANASUTHIP is a Dermatologist at Samitivej Sukhumvit Hospital. Call (02) 711 8700-2.