Sun Damage

Sun damage is something that most of us will acquire, to varying degrees, over our life time.

People who have fairer skin types are more sensitive the sun, and therefore tend to develop signs of sun damage earlier and more severe than their darker skinned counterparts. The effects of sun damage include rough skin texture, fine lines, pigmentation, dilated poor, uneven skin colour, red patches. There are a number of treatment options available to treat sun damage. The best option for each person will depend on which features of the sun damage are most prominent. For example, in someone with a lot of rough skin texture, pigmentation and open pores then CO2 laser will normally be best. For patients in whom the skin texture is not as bad, but they have a lot of redness and smaller patches of pigmentation, IPL may be more effective.

Non-surgical treatments for sun damage include:

Carbon Dioxide (CO2) Laser Resurfacing

This is broadly considered to be the gold standard treatment for more advanced sun damage. The CO2 laseworks by burning the top layers of the skin off, which in turn generates a healing response. Traditional laser resurfacing burns the entire surface of the skin off. More recently advances in ‘fractional’ technology means that only a percentage of the skins surface is removed, using microscopic laser beams. This has the effect of still stimulating a healing response, but with a shorter recovery period afterwards. The CO2 laser we use is the CO2RE from Syneron-Candela, which has the ability to work in both full field and fractional mode. For treating sun damage we normally use it in fractional mode, tailoring the settings depending on the extent of the sun damage. The down time from this procedure is usually around one week, although it can be up to 10 days with deeper treatments. With the deepest settings, there can be some persistent redness in the skin following this treatment for up to a couple of months, although this can normally be covered using make up. You will normally notice a benefit from this treatment after one session, although occasionally two or three sessions are required to achieve optimal results in the most severe cases of sun damage.

Deep Chemical Peel

Deep chemical peels can be very effective at improving sun damage. In this technique a corrosive substance is applied to the skin, burning the top layers off. The chemical used (phenol) can be bad for the heart however (cardiotoxic) so it should only be used in a hospital setting, with two doctors present so that the heart can be safely monitored. To be able to peel down to the level of the skin where the acne is based, it is necessary to go beyond the layer of the skin where the pigment producing cells live. Because of this, phenol tends to lighten or bleach the skin at the same time. This technique has fallen out of fashion since the advent of laser technology.

Lighter Chemical Peels

a course of lighter chemical peels can sometimes be used to treat sun damage. A lighter chemical peel is one using a more dilute acid, so it does not penetrate as deeply. Consequently, these have a much more rapid recovery with people usually returning to work straight away. There is normally some dry skin and peeling around days 3 – 5, although it is usually not significant enough to stop people going about their normal day-to-day activities. Normally a course of 3 or 4 treatments would be suggested, one each week. The philosophy behind this treatment is that the constant inflammation produced the more minor peels results in more collagen remodelling in the deeper layers of the skin.

Dermaroller

A derma roller is a rolling device that has hundreds of small needles attached to it. It is rolled over the skin a number of times, creating thousands of needle incisions in the skin. The theory is that this stimulates a healing response, and tissue remodelling, in the deeper layers of the skin. Smaller needles can be used by beauty therapists. When using deeper needles it can be be used by a doctor – along with local anaesthetic – to create better results. There is normally a few days of down time with each treatment. A course of 3 or 4 treatments is usually recommended.

Microdermabrasion

This is beauty therapy treatment that uses fine crystals to blast against the surface of the skin. This creates a nice exfoliating effect on the skin, and can give the skin a nice glow (similar to what you would achieve from using a glycolic cleanser or facial scrub). This is a very superficial technique that does not penetrate to the level of the acne scars).

Intense Pulsed Light (IPL)

This treatment uses very bright light, in a short burst, to target pigments within the skin. The pigments that are targeted are red and brown, which generates a burst of heat, which typically destroys red blood vessels and brown age spots. The treatment can be quite painful, but is usually over with very quickly. It is most effective for people who have sun damage where ‘dyschromia’ – uneven skin colour – is the predominant feature.

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