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Oct 13, 2021
6 min read

What is sun-damaged skin (photoaging) and how to treat it

Sun damage, also called photoaging or premature aging, is due to the sun’s UV rays damaging the skin. Common signs of sun damage include fine lines and wrinkles, dark spots, visible fine blood vessels, and an uneven skin tone. Sun damage is dangerous because it increases your risk of precancerous lesions, like actinic keratoses, and skin cancers, like basal cell carcinoma, squamous cell carcinoma, and melanoma. The best way to prevent sun damage is to use sun protection, especially broad-spectrum sunscreens, with an SPF of 30 or higher. Other treatments include retinoids, especially tretinoin, chemical peels, and laser treatments.

mike bohlchimene richa

Reviewed by Mike Bohl, MD, MPH

Written by Chimene Richa, MD

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

We’ve all heard the recommendation to wear sunscreen. But is a tan really that big of a deal? Short answer—yes! Tans, sunburns, and a lot of sun exposure all lead to sun-damaged skin, premature aging, and increases your risk of skin cancer. Read on to learn more about sun-damaged skin and what you can do about it.

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What is sun damage?

While many people love that golden bronze look, tanning is an early sign that the sun is damaging your skin. When your skin is exposed to the sun, it makes more pigment (melanin) to protect itself from the harmful rays. The sun emits different types of light and energy; visible light is the light we can appreciate with our eyes. However, there are other forms of energy we can’t see that can still affect our skin, including ultraviolet (UV) rays.

Signs of sun damage (photoaging)

Every time your skin is exposed to the sun, it receives both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Both kinds of UV rays cause damage to the skin. Sun damage causes you to look older than you naturally would, a process also called photoaging or premature aging. Signs of sun-damaged skin include (Guan, 2021): 

  • Fine lines and wrinkles
  • Dark spots (also known as “age spots”)
  • Thin blood vessels that can be seen through the skin (spider veins)
  • Uneven skin tone

Researchers believe that up to 80% of the aging changes in your skin may actually be due to UV exposure and not just getting older (Guan, 2021). Being out in the sun without appropriate protection is not the only way that you can get sun-damaged skin. Tanning, either done outdoors or inside a tanning bed, can lead to premature aging. Tanning is never healthy for your skin (Guerra, 2021-a).

Types of sun damage

Almost everyone has experienced acute sun damage, also known as sunburn. Despite wanting to protect our skin, most people have been in situations where they forgot to apply or reapply sunscreen and wound up with a sunburn. In 2015, over 30% of American adults reported having at least one sunburn within the previous year (Guerra, 2021-b). 

When you get a sunburn, you will often notice skin redness that starts a few hours later, gets worse over the next 24 hours, and then gradually improves over time. After a sunburn, your skin is often very sensitive to touch, and you may notice your skin peeling (but fight the urge to peel your skin!). In severe cases of sunburn, people can develop systemic symptoms like headache, fever, nausea, and vomiting (Guerra, 2021-b). 

Light-skinned people who sunburn can develop permanent brown spots after the burn heals—this is one of the signs of long-term sun damage. Other types of long-term sun damage include wrinkles, dry skin, dark spots (called sun spots or age spots), or other pigmentation changes.

Actinic keratosis (a precancerous lesion) is another type of long-term sun damage that can have serious consequences—namely, skin cancer. 

Dangers of sun damage to the skin

Sun damage causes more than just skin discoloration and wrinkles; it can lead to various types of skin cancer by changing the DNA in your skin cells and making them grow abnormally. 

One of the signs of these changes is the development of precancerous lesions (like actinic keratosis) or skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. You can treat most skin cancers surgically, but melanoma can be life-threatening if not recognized early. 

The more sun damage you have, the higher your chances of developing skin cancer. People with fairer skin are more susceptible to sun damage as well as skin cancer. Melanin protects against sun damage, but lighter-skinned people have less melanin in their cells, which puts them at higher risk for photoaging and skin cancer (Marques, 2021). 

Other risk factors for sun damage include high amounts of sun exposure (often due to occupation or hobbies), older age, and living in an area with significant sun radiation (e.g., closer to the equator). In other words, the more time you spend in the sun throughout your life (starting in childhood), the higher your chances of having sun damage and potentially skin cancer (Guerra, 2021-b). 

If you have or are undergoing acne treatment, you may be especially susceptible to sun damage. Acne scars exposed to UV rays may become darker or hyperpigmented. Also, some of the medications used to treat acne, like tretinoin (brand name Retin-A), can make your skin more sensitive to the sun. This means you may be more likely to get a sunburn with even mild sun exposure (Yoham, 2020).

Sun damage prevention

The best thing you can do for your skin is to prevent sun damage from occurring in the first place by using sun protection. You should apply a broad-spectrum (protects against UVA & UVB) sunscreen with at least a 30 SPF rating whenever you are going outside, even if it is a cloudy day (Guan, 2021). 

The sun’s rays are the most damaging between 10 am and 2 pm. If you are going to be outside for an extended period, reapply sunscreen every two hours, especially if you are sweating or swimming. Whenever possible, wear protective clothing like a wide-brimmed hat and sunglasses. Don’t forget that snow, water, and sand reflect sunlight and can increase your chances of sun damage. 

Lastly, avoid tanning beds as they, too, can cause photoaging of your skin. Any kind of tanning is unhealthy for your skin, and getting a tan does not protect you from sunburns or sun damage (Guerra, 2021-a).

Even if you already have premature aging, you should still protect your skin from further damage with the appropriate skincare and sun protection.

Treatment for sun-damaged skin

While prevention is key, you might be reading this after you’ve already experienced some level of sun damage. Don’t worry; there are things you can do to treat your sun-damaged skin.

Remedies for sunburns (acute sun damage)

If you get sunburned, here are some remedies to try (Guerra, 2021-b):

  • Cool compresses
  • Calamine lotion
  • Aloe vera-based gels
  • Ibuprofen for skin pain and inflammation
  • Drink lots of water
  • Avoid peeling your skin or popping blisters

People who have had significant sun exposure throughout their lives may have signs of long-term sun damage, for which the following treatments can be helpful.

Medications

The most commonly used medical therapy for long-term sun damage is topical retinoids, like tretinoin (brand name Retin-A). Retinoids are a class of medications that includes vitamin A (retinol) and other compounds made from it. They improve cell turnover and collagen production.

Studies have shown that tretinoin can improve fine wrinkles, skin looseness, brown spots, and the overall appearance of sun-damaged skin. However, it can take several months for these improvements to show. Some people will have redness, itching, dryness, and skin irritation during the first few weeks of use (Yoham, 2020). 

Also, tretinoin can increase your skin’s sensitivity to the sun and make you more likely to sunburn. You must apply sunscreen if you are using retinoids. People who are pregnant or breastfeeding should not use tretinoin. Other retinoids include tazarotene and adapalene (Riahi, 20216).

There is limited evidence that other compounds in skincare products may also help improve the appearance of sun-damaged skin, including (Guan, 2021): 

  • Antioxidants (e.g., niacinamide and coenzyme Q10)
  • Vitamins (e.g., vitamin C and vitamin E)
  • Hydroxy acids (e.g., alpha-hydroxy acids and beta-hydroxy acids)
  • Plant extracts (e.g., green tea, Ginkgo Biloba, ginseng, and grape seeds)

Chemical peels

Chemical peels are minimally invasive procedures that can treat photoaging. They use harsh chemicals to remove the outer layer of skin to promote skin regrowth, which helps even out the skin tone and tightens loose skin (Samargandy, 2021).

Chemical peels can affect the outermost layer of skin, or they can go deeper, depending on the strength of the peel. The stronger the peel, the deeper it goes; the strongest peels are usually used for people with severe sun damage. Superficial peels have minimal side effects, while moderate to deep peels have the potential adverse effects of skin coloration changes, infection, and scarring (Samargandy, 2021).

Laser treatment

For some people, laser treatments may be an option to improve the signs of premature aging. You may be a candidate for laser therapy depending on your skin tone, amount of sun damage, and other factors. Several different lasers exist, each with varying degrees of effectiveness, required downtime, and associated risks.  

Most people deal with some level of sun damage during their lives, especially as the damage starts in childhood. The best thing that you can do to keep your skin looking young and healthy is to apply sunscreen every day and reapply it every two hours if you are in the sun for an extended period. There are options for treating existing skin damage, but you also need to prevent future photoaging for the treatments to be effective. And remember that tanning is never healthy, whether from the sun or tanning beds.

References

  1. Guan, L. L., Lim, H. W., & Mohammad, T. F. (2021). Sunscreens and photoaging: a review of current literature. American Journal of Clinical Dermatology, 1–10. Advance online publication. doi: 10.1007/s40257-021-00632-5. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361399/
  2. Guerra, K. C., Zafar, N., & Crane, J. S. (2021-a). Skin cancer prevention. [Updated Aug. 14, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 7, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK519527/
  3. Guerra, K. C., Urban, K., & Crane, J. S. (2021-b). Sunburn. [Updated Aug. 4, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 7, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK534837/
  4. Marques, E. & Chen, T. M. (2021). Actinic keratosis. [Updated July 18, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 7, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557401/
  5. Riahi, R. R., Bush, A. E., & Cohen, P. R. (2016). Topical retinoids: therapeutic mechanisms in the treatment of photodamaged skin. American Journal of Clinical Dermatology, 17(3), 265–276. doi: 10.1007/s40257-016-0185-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26969582/
  6. Samargandy, S. & Raggio, B. S. (2021). Skin resurfacing chemical peels. [Updated July 25, 2021]. In: StatPearls [Internet]. Retrieved on Oct. 7, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK547752/
  7. Yoham, A. L. & Casadesus, D. (2020) Tretinoin. [Updated Dec. 5, 2020]. In: StatPearls [Internet]. Retrieved on Oct. 7, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK557478/