By Barret Wertz
During the winter, the last thing you may be thinking about is sun damage—and with colder weather, shorter days, and more skin coverage, why would you? The answer is because now is the perfect time to take action to reverse it, especially if you weren’t super diligent about wearing sunscreen everyday during the summer. UV damage leads to around 90 percent of the appearance of aging in our skin. After wrinkles, the most visual effects of sun damage are dark spots—freckles, age spots, and liver spots—that show up on the skin, otherwise known as hyper-pigmentation. Once these suckers rise to the surface, there isn’t much you can do on your own to get rid of them. There are plenty of costly creams you can buy to try to reverse the damage done, but the truth is, only trained professionals can remove them.
To help get you started on that pending doctor’s visit (which should happen soon since winter is when you’re covered up and inside the most anyway) we went ahead and got the ball rolling with one of the best in the business. We asked Dr. Jeremy Brauer, an assistant professor at NYU Langone Health’s Department of Dermatology, a few questions to address any of those doubts you may have in mind about going in and getting those spots checked out.
Men’s Journal: What is sun damage exactly?
Jeremy Brauer: Sun damage is what happens to your skin after exposure to the various wavelengths (we mostly talk about UVA and UVB) of the sun. When we discuss the clinical appearance of sun damage (i.e. what we see in the mirror or during a total body skin exam) it can encompass a wide range of findings. These include, but are not limited to, cosmetically concerning lesions such as light and dark, flat and raised, small and large brown spots, irregular or mottled or uneven pigmentation, red spots, blood vessels, redness, textural changes, fine lines; but more importantly, sun damage can lead to the development of precancerous lesions and skin cancer, including actinic keratoses, basal cell carcinoma, squamous cell carcinoma and melanoma.
MJ: Do you find men come in for to assess overall sun damage, or to address something specifically?
JB: Whereas women will come in more commonly to discuss treatment options for their sun damaged skin (i.e. spots, fine lines, laxity), with the idea of improving the look of their whole face or chest for example, men more often will come in asking about what they can do for a specific “spot” of concern (“What can I do about this brown spot”). From there we discuss the diagnosis, origin and possible treatment options.
MJ: How long is the period of time from initial sunburn until visible long-term damage?
JB: That’s a great question. In general, I tell patients that what we are seeing currently is evidence of years of prior sun damage. However, and most importantly, that does not mean that they should not protect their skin from the sun now and in the future.
MJ: What are you looking for in a topical treatment of sunspots?
JB: Certain conditions that are worsened by the sun, such as melasma or post-inflammatory pigmentation can be treated with several different topical agents. However, I do not recommend a topical treatment specifically for sunspots. I will say, the two musts are a broad spectrum (UVA/UVB) sunscreen and topical retinol in any anti-aging, healthy skin regimen. Otherwise, traditional treatments have included chemical peels, liquid nitrogen—like you would use on a wart—and other means of destruction [of the sun spot cells]. More commonly, I prefer the use of lasers that are designed to specifically target pigment [such as a fractal or fractional laser].
MJ: At what point should someone get a chemical peel or a laser treatment?
JB: The question of when is the right time to begin treatment should be decided by the patient and treating physician, as individual circumstances vary. Some patients are looking at treatments from a preventative perspective, while others already have evidence of significant damage and are looking for treatment. The best bet is to make an appointment and see a dermatologist, and go from there.
MJ: Do aggressive sun damage reversal techniques hurt?
JB: Just as there are many signs of sun damage, there are also many treatment options. Some, more aggressive resurfacing devices can be painful. At the same time, a series of injections with a neurotoxin [such as Botox] or hyaluronic acid [in a filler such as Juvederm] could also be painful to the patient. The worse the damage, the more a chance of pain in the reversal process.
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