What are the other Names for this Condition? (Also known as/Synonyms)

• Dermatoheliosis
• Farmer’s Skin
• Sailor’s Skin

What is Photoaging? (Definition/Background Information)

• Photoaging occurs due to repeated injury to skin from sun damage; from prolonged and regular sun exposure (exposure to ultraviolet radiation) that takes place over many years. The condition can be described as a kind of premature skin aging
• The severity of the condition depends upon two factors - the duration and intensity of sun exposure. Photoaging is a common condition that is usually seen in adults over the age of 40 years
• The affected regions typically include, body areas exposed to the sun, such as the face, neck, bald portion of the scalp, hands, and even the chest. Photoaging can lead to complications such as solar lentigines and even melanoma (a malignant skin condition)
• Photoaging is treated using topical medications and photo-rejuvenation procedures. The prognosis with adequate treatment is usually good. However, the condition can progress to result in irreversible damage to the skin

Who gets Photoaging? (Age and Sex Distribution)

• Photoaging is generally observed in adults who are exposed to ultraviolet light (from the sun), above 40 years of age
• In general, men are higher prone to Photoaging than women (possibly due to the nature of their occupation)
• There is no racial or ethnic preference observed. However, light-skinned individuals (such as Caucasians) are more prone to the condition than dark-skinned individuals (such as Africans or Asians)
• Generally, individuals in latitudes around tropical areas and individuals living in higher altitudes have a higher risk

What are the Risk Factors for Photoaging? (Predisposing Factors)

The risk factors for Photoaging include:

• Exposure to intense sun for long periods during the course of work, or due to participation in outdoor sports and other activities
• Those who work outdoors when sun intensity is at its highest for many years; the sun is a big source of ultraviolet light and the highest exposure occurs around noon
• People living in tropical or subtropical geographical regions
• People living at higher altitudes
• Those with sensitive skin, who get easily sunburned
• Fairer-skinned individuals have a greater risk than darker-toned individuals

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Photoaging? (Etiology)

• Photoaging is caused from prolonged exposure to the sun’s ultraviolet (UV) radiation for many years or decades. This results in chronic skin damage from the UV light
• The longer the period of exposure and the more severe the sun’s intensity, the greater is the severity of Photoaging
• Hence, any profession or occupation that involves a regular and chronic exposure to sunlight is a potential risk factor

What are the Signs and Symptoms of Photoaging?

Photoaging is a very common skin condition with signs and symptoms that includes:

• Atrophy of skin
• Hypo and hyperpigmentation
• Wrinkled skin (premature aging)
• The skin may become thin and can cause easy bleeding. Photoaging can cause small dilated blood vessels on skin (telangiectasia), which can bleed. This condition is known as spider veins
• These signs and symptoms occur on skin areas that have been exposed to the ultraviolet light. Generally, non-exposed areas do not show these features
• Typical body regions affected include: Face and lips, hairless portion of the scalp, neck, arms (hand, forearm), and chest
• Like fair-skinned individuals, dark-skinned individuals are also affected. The severity depends upon the amount of UV light exposure and the period of exposure

How is Photoaging Diagnosed?

A diagnosis of Photoaging is made by:

• Physical examination of the skin (lesion) and medical history evaluation, including history of one’s work/occupation. This is usually sufficient to arrive at a diagnosis; although in rare cases, a biopsy may be performed
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Photoaging?

The possible complications due to Photoaging may include:

• It is a progressive condition that can lead to irreversible sun damage
• Solar lentigines - an abnormal skin pigmentation condition
• Secondary or superimposed infections due to bacteria or fungus
• Cosmetic issues in some individuals
• Longstanding Photoaging can result in the development of melanoma (common types of skin cancer)

How is Photoaging Treated?

Commencing early treatment can help prevent progressive worsening of Photoaging and avoid complications. The treatment measures available include:

• Topical treatment using tretinoin, retinol, tazarotene, and other retinoids
• Topical vitamin C formulated to enhance penetration and prevent premature oxidation
• Other “cosmeceuticals” which have utility in reversing Photoaging including copper peptides, and many other active ingredients
• Topical medications which can affect the hyperpigmentation and variable pigmentation include hydroquinone, kojic acid, and azelaic acid
• Chemical peels can affect pigment and texture issues
• Intense pulsed light (IPL) and a variety of laser treatments for pigment changes (solar lentigines)
• Multiple methods of “repeated minor wounding” of the affected areas can induce fibroblasts to become more metabolically active to make new collagen. These include:
  • Microdermabrasion
  • Microneedling
  • Radiofrequency treatments
  • Fractional laser treatments

How can Photoaging be Prevented?

A few methods to prevent Photoaging may include:

• Avoid prolonged and chronic exposure to the sun
• If this is unavoidable (like due to an occupational requirement), then take safety steps to reduce exposure to the UV rays, by using sunscreens with high sun-protection factor, wide brimmed hats and protective clothing
• Be aware of the hazards of prolonged sun exposure and take steps to protect yourself. Modify your profession to stay out of the sun during the period, when it is the most intense
• Individuals who are regularly exposed to the sun, or work under the sun should get their skin periodically examined by a physician. This is crucial if they suspect, or if there are any noticeable skin changes
• Keep yourself well-hydrated, if sun-exposure for prolonged periods is unavoidable

What is the Prognosis of Photoaging? (Outcomes/Resolutions)

• The prognosis of Photoaging is good with appropriate early treatment
• However, in case of delayed treatment or further unprotected exposure to the sun’s rays, it may result in irreversible skin damage
• There is a rare chance that some cases may develop to form invasive skin cancers, when chronic sun exposure and other risk factors are high

Additional and Relevant Useful Information for Photoaging:

• Sunburn is another skin condition that is caused by ultraviolet rays of the sun. It occurs when skin cells are burnt or damaged from exposure to the UV component of the sun

The following article link will help you understand sunburn:

https://www.dovemed.com/diseases-conditions/sunburn/