Avoiding Wrinkles, or Worse.

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Dr. Arnold

Avoiding Wrinkles, or Worse.

By

Roy M. Arnold, MD

Summer is upon us, or soon will be. That means outdoor activities will be plentiful. That also means exposure to the blazing sun while gardening, golfing, playing sports or just lounging. It is very important for your skin’s health that exposure to ultraviolet rays from the sun or tanning beds be limited as much as possible. You might think, “Wait, I thought a tan was supposed to be healthy?” The facts are that exposure to sunlight or artificial UV light contributes to most of the common skin maladies that plague us all including fine and coarse wrinkles, freckles, age spots, sagging skin, dilated blood vessels, precancerous growths and skin cancer.

If you weren’t already aware of it, skin cancer is the most common cancer in the US accounting for about 2.5 million cases per year. One of the types of skin cancer, melanoma can be deadly. There are about 60,000 cases of melanoma per year accounting for 9000 deaths. The single most common risk factor for melanoma is sun exposure, particularly among fair-skinned individuals or people who have had severe cases of sunburn. Many years may elapse between the original injury and the development of malignancy. Melanoma usually begins as a pigmented spot that is irregular in shape, irregular in color and about the size of a pencil eraser. Many melanomas occur on the back or the back of the legs where it is hard to check the progress. Any suspicious skin lesion that shows these characteristics should be promptly evaluated by a healthcare professional.

Other types of skin cancer, though less dangerous, can still cause problems if not treated promptly. They usually occur on the face, arms, or shoulders although they can occur virtually anywhere. These can present as a scaly patch that doesn’t itch and doesn’t go away. They may develop ulceration and may have rolled edges around the ulcer. In the early stages, removal is usually curative. Make a habit of checking your skin monthly all over in a full length mirror so that you become familiar with any moles or blemishes. Any spots that appear suspicious should be observed for changes and evaluated further by a health care professional.

OK, now what? How does one go about preventing the kind of damage we’re talking about here? First and foremost is to take protective measures when going outside, even on cloudy days. Wear sunglasses with total UV protection, a hat with a brim, long sleeves and cover pale skin. Use sunscreen of at least SPF 15 that protects against both UVA and UVB rays and reapply every 2 hours. Sunscreen can be very irritating to the eyes, so avoid using it near your eyes and wash your hands after applying. Using a sunscreen that also contains zinc oxide or titanium dioxide can improve UV protection. Avoid sun exposure entirely when the rays are most intense, between 10am and 3pm. Make certain children are covered and protected when playing outdoors. Limit their sun exposure to 2 hours maximum per day. Above all avoid the use of tanning beds. If you must be tan, use a topical tanning product.

If you already have sun-damaged skin, besides preventing further damage by limiting sun exposure, what can be done about wrinkles and spots? Many dermatologists suggest using a moisturizing cream

that contains antioxidants like vitamins C and E plus retinol. It’s not necessary to spend lots of money on these, the drugstore brands are usually just as good as the $49.95 Department store brands.

Using an exfoliant before bed can help rejuvenate skin cells and stimulate collagen production. Sometimes preparations containing alpha-hydroxy acids can be useful in stimulating new growth, however they make the skin even more sensitive to damage from UV rays. Age spots may respond to treatment with an over-the-counter cream containing hydroxyquinolone. If your budget permits and you are so inclined, professionally administered laser treatments or injections like Juviderm® or Restylane® can improve facial appearance. No matter what method you select be realistic about your expectations. Nothing will make you look like a teenager again.

One final word – exposure to sunlight has one beneficial effect. It stimulates skin cells to produce vitamin D which is essential for bone health. A survey performed in 2005 found an overall prevalence of vitamin D deficiency of 41% among otherwise health US adults. The highest rate of deficiency was among those who were obese, Black or Hispanic. Given that there are few really good food sources of vitamin D (one would have to eat a can of tuna daily to meet the minimum requirement) most people should consider taking a supplement of 1-2000 units daily. The capsules can be found in the supplement aisle of any drugstore and are inexpensive.

Have fun this summer, but take precautions. Wear sunglasses, hats, protective clothing and sunscreen.