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

• Actinic Elastosis
• Elastosis Senilis

What is Solar Elastosis? (Definition/Background Information)

• Solar Elastosis is a skin condition that develops from photoaging, wherein the aging skin is damaged from long-term and excessive exposure to sunlight (ultraviolet radiation). This causes the exposed skin areas to thin or thicken and turn bronzed and wrinkled
• Photoaging describes a process of repeated injury to skin from sun damage. Solar Elastosis can affect the skin and eyes; the condition is observed in people of all skin types who are chronically exposed to sun. It is also known as Actinic Elastosis
• Solar Elastosis refers to diffuse sun-induced aging. Chronic sun exposure as well as intermittent burns also leads to increased risk for skin malignancies such as basal cell carcinoma of skin, squamous cell carcinoma of skin, and melanoma of skin
• Solar Elastosis can lead to complications, such as irreversible skin damage, if it is not adequately managed. The treatment may involve topical medications, laser therapy, and photo-rejuvenation procedures

Who gets Solar Elastosis? (Age and Sex Distribution)

• Solar Elastosis is generally observed in adults over 40 years of age
• Both males and females are equally affected, although a greater number of cases may be noted in men due to their nature of occupation causing increased sun exposure
• Worldwide, there is no racial or ethnic preference observed
• However, individuals living in latitudes around tropical regions and those at higher altitudes have an increased risk for Solar Elastosis

What are the Risk Factors for Solar Elastosis? (Predisposing Factors)

The risk factors for Solar Elastosis 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 (especially around noon) for many years
• People living in tropical or subtropical geographical regions
• People living at higher altitudes
• Airline pilots and aerospace travelers flying at very high elevations
• Chronic smoking is also risk factor due to the long-term effects of tobacco smoke on skin
• Individuals with weak immune system

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s 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 Solar Elastosis? (Etiology)

Solar Elastosis is caused from prolonged exposure to the sun’s ultraviolet (UV) radiation for many years. This results in chronic skin damage from the UV rays.

• The condition causes an abnormal accumulation of fragmented, poorly-functioning elastin (a type of protein) in the superficial skin layers. The process may be described as a protective response of skin to excess sun exposure
• Elastin is the structural skin protein that gives the skin its “snap back” property, shaping it to the underlying contours. It is present in the connective tissues
• Individuals exposed to tobacco smoke have an increased risk for breakdown of the skin, damaging the deeper skin layers. Thus, chronic smokers, who are also exposed to direct sunlight for several years, have a very high risk for Solar Elastosis owing to the combination of factors

What are the Signs and Symptoms of Solar Elastosis?

The signs and symptoms of Solar Elastosis may include:

• Thinning and thickening and bronzing of skin; the brownish-yellow discoloration appears more pronounced in fair-skinned individuals than dark-skinned individuals
• Prior to bronzing of skin, the affected skin areas may appear reddish for many years
• The dry and thinned or thickened skin presents irregular ridges and wrinkles that crisscross each other (signs of premature aging)
• These signs and symptoms occur on skin areas that have been exposed to ultraviolet light. Generally, non-exposed areas do not show these features
• Typical body regions affected include the face and lips, hairless portion of the scalp, neck, arms (hand and forearm), and chest

How is Solar Elastosis Diagnosed?

A diagnosis of Solar Elastosis may involve the following exams and procedures:

• Physical examination of the skin (lesion) and medical history evaluation, including history of one’s work/occupation and smoking. This is usually sufficient to arrive at a diagnosis; although in rare cases, a biopsy may be performed
• Skin biopsy: A skin tissue 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

A differential diagnosis to eliminate other skin conditions may be needed before arriving at a definitive diagnosis. These may include:

• Actinic keratosis
• Keratoelastoidalis marginalis

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 Solar Elastosis?

The possible complications due to Solar Elastosis may include:

• It is a progressive condition that can lead to irreversible skin damage
• Cosmetic issues
• Individuals with light skin and blonde or red hair have a greater risk for actinic keratosis and cutaneous carcinomas
• Longstanding Solar Elastosis can result in the development of melanoma (a common form of skin cancer)

How is Solar Elastosis Treated?

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

• Use of topical ointments, lotions, and creams
• Microdermabrasion and dermabrasion
• Use of dermal fillers for deep furrows
• Laser ablation therapy
• Photo-rejuvenation therapy
• Botulinum toxin injections (neurotoxin injections)
• Removal of the entire affected skin layer by cosmetic resurfacing procedure

Regular follow up visits with the healthcare provider is important and recommended, to early detect any malignant transformations (skin cancers).

How can Solar Elastosis be Prevented?

Solar Elastosis may be prevented by considering the following steps:

• Avoid prolonged and chronic exposure to the sun
• If this is unavoidable, such as 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 UV protective clothing
• Be aware of the hazards of prolonged sun exposure and take steps to protect yourself. Consider modifying the 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 skin cancer, or if there are any noticeable skin changes
• Keep yourself well-hydrated if sun-exposure for prolonged periods is unavoidable
• Cessation of smoking, including secondhand exposure to tobacco smoke

What is the Prognosis of Solar Elastosis? (Outcomes/Resolutions)

The prognosis of Solar Elastosis may be improved with appropriate early treatment.

• In case of delayed treatment or further unprotected exposure to the sun, it may lead to irreversible skin damage
• Some individuals have a high risk for skin cancer (melanoma), particularly when the precipitating factors are not controlled such as sun exposure and/or smoking

Additional and Relevant Useful Information for Solar Elastosis:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/skin-disorders/