Additional Strategies For Sun-Damaged Skin

By Anita Saluja, M.D.

My patients usually know the basics of sun protection: I tell them to:

• Get the recommended amount of vitamin D safely through a healthy diet and vitamins and not rely on the sun.
• Avoid tanning and especially, do not burn! One blistering sunburn doubles your risk of the deadliest form of skin cancer, melanoma.
• Choose doing outdoor activities in the morning and evening, if possible. If you are out longer than fifteen minutes, wear sunscreen of SPF 30 or higher.
• Make sure the sunscreen blocks against UVA and UVB ultraviolet rays. Apply a thick layer and reapply every two hours.
• Wear a three-inch wide-brimmed hat. Wear sunglasses to protect eyes from cataracts and eyelid cancer.
• Most importantly, teach your children good sun-protective practices.

What else can one do?

Prevention of Sun Damaged Skin

• C E Ferulic. A Topical Antioxidant: Ferulic acid is present in the cell walls of grains, fruits, and vegetables. It is a potent antioxidant, protecting skin from ultraviolet rays. Vitamins C and E, if in appropriate formulations, work together with ferulic acid to reduce sunburn cells and DNA mutations associated with skin cancer. There are also anti-aging benefits. Usually, one applies Ferulic C E serum to the skin, (which can’t be washed or rubbed off once absorbed), prior to sunscreen to increase sun protection and protect against environmental stress. C E Ferulic, manufactured by Skinceuticals, is available at your dermatologist's office.
• Heliocare, Sun Protection in a Pill: Heliocare is an extract of the plant Polypodium leucomotos (a kind of fern). It is just becoming available in the United States and has been widely used in Europe since 1982. Heliocare is a potent oral antioxidant and is available over the counter as a dietary supplement. Heliocare is active within 30 minutes of the first dose. There are no known side effects. It is not a replacement for topical sunscreens or protective clothing. Its main function is to enhance the body’s ability to deal with UV that gets through topical sunscreens. There is strong scientific evidence that shows Heliocare helps prevent sunburn and sun damage that leads to wrinkles and skin cancer.
• UV Protective Clothing: There are different factors that affect the level of ultraviolet protection provided by a fabric. In order of importance these are:
  • weave (tighter is better)
  • color (darker is better)
  • weight (heavier is better)
  • stretch (less is better)
  • wetness (dry is better)

  A typical summer shirt only provides an SPF of 5 to 9. Specialized clothing such as those made by Coolibar or Solumbra provides all-day UVA and SPF30+ UVB protection. The sun protection is built into the fabric so it won’t wear off. Rit Sunguard is a laundry additive that transforms everyday clothing into sun protective gear with SPF of 30.

• Automobile Window Film: Tinting car windows with Llumar or 3M Automotive Film can reject 99 percent of UV rays. This reduces sun damage to your car’s interior, but also increases your skin protection from the sun’s rays. Ask shops that service your car, as well as your car dealer, to recommend a few stores that can tint windows.

Correction of Sun Damaged Skin

• Retinol and Retinoic Acid (Tretinoin, Retin-A): Retinol and Retinoic acid are derivatives of Vitamin A and are called retinoids. Medical research indicates that retinoids reverse sun damaged and aging skin. They reduce wrinkles and smooth skin texture via increasing collagen in the skin. They also decrease certain precancerous lesions, brown sun spots, and discoloration in the skin. Tretinoin is available by prescription only. Because Tretinoin is expensive and often not covered by insurance, many patients are interested in using over-the-counter retinol products. Recent studies of retinol, in the correct concentration, have shown it to be as effective as Tretinoin, often with less irritation. Reputable retinol products can be recommended by your dermatologist or are available in his or her office. I dispense a product called AFIRM that features the wonderful, skin improving benefits of retinol in a skin-friendly micro sponge formula.
• Pulsed Light Technology: Pulsed light systems emit pulses of light via hand pieces into the skin. The light is absorbed by the pigment in sunspots and the blood in visible vessels. The pulsed light "photofacial" rejuvenates skin by treating sun damage, sun spots, and visible veins. In our office, we offer the safe and effective Palomar Starlux Rejuvelux Process.
• Photodynamic Therapy: Photodynamic Therapy (PDT) is a special treatment performed with a topical sensitizing agent called Levulan (5-aminolevulinic acid) activated with the correct wavelength of light. For example, Levulan can be used with the pulsed light system described above. These treatments remove pre-cancerous spots called actinic keratoses. Actinic keratoses are rough, pink patches on the skin, caused by excessive exposure to the sun that can progress into skin cancers. Fine lines and blotchy pigmentation are also improved because of the positive effect of Levulan and the light treatment. Levulan is applied to the skin while the patient is in the office, is left on the skin for a period of time, usually an hour, and then the 20 to 30 minute light treatment begins. PDT is noninvasive, well tolerated, and has an excellent cosmetic outcome.

In summary, wear your sunscreen and explore these additional strategies for sun-damaged skin. Talk to your dermatologist. There are new approaches all the time.