Can you ever reverse sun damage?

Even if you weren’t one of the thousands flooding Instagram with #holidayspam, you will still have incurred some sun damage this summer.

What begins as a ‘glow’ soon turns to dry, flakey skin and that ‘tan’ is more a collection of pigmentation spots you just can’t seem to cover.

The problem is your skin can clock up sun damage every time you’re out without protection, even if there’s not even a whiff of sun (hello today!)

But that damage doesn’t always show up until years later. So those little lines and weird brown spots you’re seeing now might have been caused by that time you turned beetroot red at brownie camp.

Though we know skin has likely been damaged if it feels painful, or tight, Dr Anton Alexandroff, consultant dermatologist at BMI The Manor Hospital says that the absence of these signs does not mean our skin hasn’t been damaged.

“Sun damage can be very subtle i.e. ‘silent’ and manifest years after sun exposure,” he explains. “It is well known that skin ageing such as wrinkles, precancerous actinic keratoses (precancerous skin changes) and/or skin cancers may develop years after excessive sun exposure.”

On a more positive note, sun damage can actually be reversed, but it largely depends on practicing safe sun from now on.

“To some extent sun damage can be reversed,” Dr Alexandroff explains. “But behavioural changes are key and it is very important to be good with sun protection in future.”

Dr Alexandroff says this includes avoidance of midday sunlight, regular frequent application of adequate amounts of sunscreen of at least SFP30 strengths (and ideally up to SPF50 strengths), wearing long trousers and long sleeved shirts and broad brimmed hats. “Avoidance of smoking is also recommended to reduce sun induced skin ageing,” he adds.

What actually happens when your skin is damaged by the sun?

“Sun damage is a complex process,” Dr Alexandroff explains. “The most common and widely known element is sun burn. This is caused by UVB. UVB rays cause DNA damage and skin cell death and sun burn usually manifest by burning and pain and redness of skin hours after sun exposure. A few days later skin peels off.”

He says that some skin cells with damaged DNA survive and may give rise to precancerous skin changes (actinic keratoses) or actual skin cancers.

“Actinic keratoses are rough or scaly patches of skin which are unsightly and may bleed and in some cases may transform into skin cancers later.”

Though UVA does not cause sun burn it is also harmful in excessive amounts and may also increase risk of skin cancers.

“Another important element of sun damage is ageing of the skin,” Dr Alexandroff continues.

“Both UVB and UVA rays age skin by destroying collagen fibres and skin elasticity and causing skin wrinkles and unsightly discolouration of the skin, also known as solar elastosis.”

Now we know what happens when the sun gets its burn on, what can we do about it?

Straight after the damage

Sunburnt? Don’t panic. “If you have got sun burn, a cool environment and cool running water are helpful,” advises Dr Alexandroff.

“Over the counter pain killers (paracetamol and ibuprofen, if there are no contraindications) can also reduce pain. And oral fluids are important to avoid dehydration,” he adds.

Though this can be done at home, if your sun burn is particularly extensive it might be sensible to see your GP.

Eat your way back to healthy skin?

“Some studies suggested that topical anti oxidants or foods rich in anti oxidants, such as vitamin C, may help to reduce skin damage cased by sun burn, but more robust clinical studies are required to confirm these initial findings,” Dr Alexandroff explains.

How to reverse sun skin ageing

According to Dr Alexandroff skin ageing can be partially reversed or improved by surgical approaches as ablative and non ablative lasers, skin peels and photodynamic therapy. But these should ideally be carried out by dermatologists or plastic surgeons.

“Precancerous skin changes called actinic keratoses can be effectively treated by topical preparations which activate body immune system, by cryogenic therapy (cryotherapy) and by a recently developed treatment called day light photodynamic therapy.

The latter has the advantage of treating large areas of photo damaged skin simultaneously in one session with minimal discomfort.

“If skin cancers develop they are usually treated by surgery or photodynamic therapy. Cryotherapy, surgery and photodynamic therapy are administered by dermatologists and plastic surgeons.”

Over the counter products

Thankfully there are now a number of over the counter topical preparations, which can help to reduce and sometimes partially reverse skin ageing.

“These preparations contain anti oxidants such as vitamin C and K, and/or retinoids – derivatives of vitamin A. Topical retinoids are often relatively harsh treatments but probably the most effective topical preparations to slow down or reverse skin ageing caused by sun damage.

“Retinols are less effective and less irritant variant of retinoids and are available over the counter,” he adds.

According to Dr Alexandroff, the successful treatment of damage reversal depends on what we are treating and on patient characteristics.

“Actinic keratoses, precancerous sun damaged skin, can be usually treated successfully in the majority of patients with topical treatments, which activate the immune system, cryotherapy or photodynamic therapy.

“Skin ageing can be improved and even partially reversed to relatively successfully in the majority of patients,” he continues.

“The majority of skin cancers can be treated successfully with surgery, photodynamic therapy and if suitable by radiotherapy.”

Dr Alexandroff advises we carry out regular self-examinations of skin to help identify potential skin cancers and precancerous lesions.

“However, prevention of the sun induced skin damage should be the main approach,” he adds.

So don’t put away that sun cream just yet, even if it does look like summer in the UK may well be over

*sobs*

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