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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 try to protect itself from the harmful rays. Our 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 that we can’t see, but that can still affect our skin, including ultraviolet (UV) rays.
- 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.
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. The American Academy of Dermatology (AAD) describes sun-damaged skin as (AAD, n.d.):
- 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
It is thought that up to 80% of the aging changes in your skin may actually be due to UV exposure and not just getting older (Amaro-Ortiz, 2014). 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.
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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. These changes can lead to the development of precancerous lesions (like actinic keratosis) or skin cancers, including basal cell carcinoma, squamous cell carcinoma, and melanoma. While most skin cancers can be treated surgically, melanoma can be life-threatening if it is 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. Other risk factors for sun damage include high amounts of sun exposure (often due to occupation or hobbies), older age, male sex, 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 (Chien, 2020).
If you have or are undergoing treatment for acne, you may be especially susceptible to sun damage. Acne scars that are 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.
Prevention and treatment for sun damage
The best thing you can do for your skin is to prevent sun damage from occurring in the first place by using sun protection. According to the AAD, you should apply a broad-spectrum (protects against UVA & UVB) sunscreen with a rating of at least 30 SPF whenever you are going outside, even if it is a cloudy day. 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 (AAD, n.d.). Any kind of tanning is unhealthy for your skin, and getting a tan does not protect you from sunburns or sun damage. Even if you already have premature aging, you should still protect your skin from further damage with the appropriate skincare and sun protection.
Sunburns (acute sun damage)
Despite wanting to protect our skin, most people have been in situations where they forgot to apply or reapply sunscreen and ended up with a sunburn. In 2015, 31% of American adults reported having at least one sunburn within the previous year (Young, 2020). When you get a sunburn, you will notice skin redness that starts about 3–6 hours later, is worse 12–24 hours after exposure, and then improves around 72 hours after being in the sun (Young, 2020). After a sunburn, your skin is often very sensitive to touch, and you may notice skin peeling (Young, 2020). Light-skinned people who sunburn can develop permanent brown spots after the burn heals (Young, 2020). In severe cases of sunburn, people can develop systemic symptoms like headache, fever, nausea, and vomiting.
If you get sunburned, here are some remedies to try (Young, 2020):
- 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
Long-term sun damage
People who have had significant sun exposure throughout their lives may have signs of long-term sun damage. There are a few things that can be done to improve the appearance of long-term sun damage.
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. Studies have shown that tretinoin can improve fine wrinkles, skin looseness, brown spots, and the overall appearance of sun-damaged skin (Mukherjee, 2006). 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 (Mukherjee, 2006). 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. Women who are pregnant or breastfeeding should not use tretinoin. Other retinoids that may be used include tazarotene and adapalene (Chien, 2020).
There is limited evidence that other compounds may also help improve the appearance of sun-damaged skin, including (Chien, 2020):
- 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 are minimally invasive procedures that can treat photoaging. They work by using harsh chemicals to remove the outer layer of skin. This promotes skin regrowth, which helps even out the skin tone and tightens loose skin (Chien, 2020). 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 changes in skin coloration, infection, and scarring (Chien, 2020).
For some people, laser treatments may be an option to improve the signs of premature aging. Depending on your skin tone, amount of sun damage, and other factors, you may be a candidate for laser therapy. Several different types of laser exist, each with varying degrees of effectiveness, required downtime, and associated risks.
Sun damage is an issue for most people, 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, to be effective, you also need to prevent future photoaging. And remember that tanning is never healthy, whether from the sun or tanning beds.