Photodamage

Photodamage refers to changes in the skin related primarily to excessive sun exposure. Skin aging is inevitable and consists of 2 modes. Intrinsic and extrinsic. Intrinsic or internal skin aging relates the changes at cellular level with advancing age. Extrinsic or external aging relates to external factors that contribute to skin aging such as pollution, smoking, and most importantly ultraviolet light exposure. The effects of the latter on the skin are referred to as photodamage. 

Photodamage presents clinically with skin roughness, areas of discolouration, sun spots, wrinkles, and the development of skin cancers or its precursors. Every person responds differently to factors related to skin aging with many variables involved including background of skin colour, skincare routine, and underlying skin diseases. It is therefore essential that in particular fair skin individuals to use sunscreen and adequate sun protective measures to minimise effects of photodamage.

Photodamage itself cannot be reversed or completely halted and therefore prevention remains the best treatment but there are many treatment options available to treat the visible effects of photodamage such as wrinkles, discolouration and rough texture of the skin. Treatments for photodamage include botulinum toxin injections, dermal fillers, chemical peels, laser resurfacing and very importantly appropriate skincare regimens.

Wrinkles can be treated with botulinum toxin injections and fillers. Based on the type of wrinkle and its severity the choice of treatment will be made and in some cases it can be the combination of both treatments. Laser resurfacing is an excellent choice of treatment to address photodamage as it improves the appearance of lines and wrinkles, clears sun-induced discolouration, and smoothens the surface of the skin giving a younger, healthier look with more luminosity. 

Skincare is a vital part of prevention and management of photodamage and consists firstly of a broad sunscreen which blocks UVA, UVB and ideally visible light too. Topical anti-oxidants such as polyphenols and vitamin C are really important to synergistically enhance the sun protection and protect against harmful free radicals. A cream that regulates skin exfoliation and strengthens its integrity is needed too such as a retinoid or alpha-hydroxy acid preparations. It is therefore essential to see a dermatologist for appropriate assessment of the severity of photodamage (Glogau severity scale exists) and a personalised treatment approach given.

Professor Firas Al-Niaimi has published extensively on botulinum toxin, fillers and vitamin C and these articles can be found under the publications section of the website.