How to recognize, treat and prevent sun-damaged skin

What are the signs of sun-damaged skin? 

Dryness

When skin is exposed to the sun without being protected, one of the first immediate effects is that it dries out. This happens to all types of skin, although skin that is already dry and dehydrated is most affected. UV rays and heat increase Trans Epidermal Water Loss (TEWL)¹ and alter the hydrolipidic film protecting the skin. The skin barrier is no longer as effective², making the skin more vulnerable to external stressors. It becomes duller, rougher and more reactive. Wrinkles are more noticeable. 

Sunburn

Sunburn occurs when skin is overexposed to UV rays³. The skin becomes red, hot and sometimes wrinkled as it dries out. Fluid-filled blisters may appear. These external symptoms indicate that the skin has been burned (first or second-degree) by the sun’s rays. In addition to visible signs of sun-damaged skin, sunburn can also cause cell damage with potentially serious consequences.

• The amount of UV radiation required for skin to burn varies from person to person, depending on their skin type, the intensity of radiation and length of exposure³.
• Sunburn can occur from just one hour after initial exposure and last up to 3 days³. The sun-damaged skin will peel after several days and may remain sensitive once the top layer of skin has flaked away.

• Regular sunburns during childhood can increase the risk of skin cancer later in life³. UVB rays responsible for sunburn insidiously alter skin cell DNA⁴ and this invisible cell damage can contribute to skin cancer in the long term.

   

Photoaging

Sun-induced skin aging accounts for 80% of all skin aging⁵. Photoaging is the medical term for accelerated premature skin aging caused by exposure to solar radiation including UVA and UVB rays. The effects are the same whether you are exposed to natural or artificial UV, for example, in a tanning salon. 

• Unlike natural chronical skin aging, photoaging isn’t related to genetics or age.
• The effects are directly related to the amount of radiation to which the skin is exposed over the years. 
• Signs of photoaging are mainly located in areas most exposed to the sun including the face, neck, décolleté, back of the hands, arms and legs.

Vascular and pigment changes

Other signs of sun-damaged skin include:

• UV rays can damage blood vessels and increase the risk of spider veins, telangiectasia⁶, resulting from the permanent dilation of tiny blood vessels that form a blue or red network on the surface of the skin.  
• Over time, repeated UV exposure can disrupt the production of melanin leading to the appearance of pigmentation marks⁷ including patches, melasma, freckles, liver spots (lentigines) and age spots. The skin colour becomes uneven, often with lighter patches on the arms, legs or back of the hands.  

Skin texture and elasticity 

Solar radiation increases the number of free radicals, which are responsible for the oxidative stress that accelerates skin aging. When they penetrate the skin, UV rays break down collagen fibres and modify elastin production⁸. Sun-damaged skin therefore changes texture and loses elasticity with increasingly noticeable sagging.

Lines, wrinkles and lesions

Wrinkles and lines are one of the most visible effects of photoaging⁹. This is because the skin dries out and the quality of the collagen and elastin is degraded following repeated exposure to UV, infrared and visible light. The epidermis gets thinner and weaker. Sun-damaged skin is less supple and may crack. Wrinkles form and deepen over time.

DNA damage and increased cancer risk

Damage caused by the sun can go far beyond photoaging. UVA rays damage the eyes, skin DNA and contribute to skin cancer, in particular melanoma. Applying sun protection is therefore essential in all circumstances throughout the year.

What causes sun damage?

UVA radiation

UVA radiation plays the biggest role in photoaging.

• Penetrating deep into the dermis, UVA rays increase the production of free radicals responsible for oxidative stress and cell damage. 
• The structure of the cells and connective tissues are altered, collagen fibres are broken down, and elastin production is disrupted. The skin loses its firmness and lines and wrinkles appear⁷.
• Increased oxidative stress can contribute to some forms of skin cancer. 

UVB radiation

UVB rays have short and long-term effects on the skin.

• In the short term, they can cause sunburn
• In the longer term, they alter the structure of skin cell DNA leading to an increased risk of developing cancer¹⁰. They also damage the eyes with a higher risk of cataracts. 

Infrared

Infrared rays are invisible but create a feeling of warmth on the skin. They can partially penetrate skin and have negative effects when combined with UV rays including:

• Dehydration
• Inflammation
• Cell damage through increased oxidative stress¹¹
• Breakdown of collagen and elastin¹¹

Visible light

Visible light also damages skin. High energy visible light (HEV) can reach the dermis, leading to: 

• Increased production of free radicals¹² and oxidative stress
• Hyperpigmentation⁷ including melasma 

Who is most at risk of sun-induced skin damage?

We aren’t all equal when comes to the risks of sun exposure. Many different criteria can influence the way your body reacts and its capacity to defend itself from solar radiation. 

Genetic and physical traits

• Having lighter skin, blue or green eyes and red/ginger, blond or light brown hair increases the risk of sunburn 
• Having darker matte skin increases the risk of hyperpigmentation 
• Having lots of beauty spots and freckles often means your skin is sensitive to the sun 

Personal and family medical history

If anyone in your family has suffered from cancer, in particular melanoma, this represents an additional risk factor.  

Environmental and lifestyle factors

• Living or spending your holidays in very sunny destinations, particularly at altitude 
• Alternating long periods indoors with sudden, intense periods of sun exposure for several days, for example, on holiday 
• Spending a lot of time outside as a child or as part of your job, in particular high-risk professions like farmers and agricultural workers, pilots, lorry drivers and gardeners 
• Regularly going to tanning salons  

Health conditions

Some pathologies and conditions can make your skin more sensitive to the sun:

• Auto-immune diseases such as lupus and conditions that weaken the immune system like HIV.
• Organ transplants.
• Medication that reduces the immune response used treat conditions such as arthritis, asthma, rheumatoid arthritis, psoriasis, inflammatory bowel disease and cancer. These include corticosteroids, biologics, monoclonal antibodies and calcineurin inhibitors.
• Certain antibiotics, isotretinoin for acne, antidepressants, antifungals, neuroleptics, some treatments for cancer and diabetes.

What should I do if I have sun-damaged skin?

If you notice signs of sun damage, it is best to act quickly. The right approach will depend on the symptoms. 

My skin is dry after UV exposure

The first thing to do is hydrate the skin by applying moisturizer formulated with humectants (to attract water) and emollients (to soften the skin) several times a day. This will increase water content and nourish the skin to restore hydration, suppleness and comfort, while also reinforcing the skin barrier. 

• Avoid ingredients that stimulate cell renewal like retinol, AHA and BHA
• Drink lots of water 
• Limit showers and baths, as they may dry the skin even more

I have painful sunburn after UV exposure

In most cases, sunburn behaves like a first-degree burn with damage to the outer layer of the skin. If the damage is deeper and the skin blisters, you probably have a second-degree burn and should seek medical advice.

• Move into the shade and drink lots of water
• You may want to cool the affected area with cold or room-temperature water or compresses (no soap or ice) 
• If you have a high temperature, feel unwell or get an intense headache, consult a doctor immediately 
• Take a painkiller if necessary
• Apply a hydrating after-sun product or post-burn repair cream – if the burn is more serious
• Keep a close key on any changes including blisters to avoid infection

How can I prevent sun damage to my skin?

Here are some practical tips to help you prevent photoaging and avoid sun damage.

Wear broad-spectrum sunscreen every day

Now that scientists have a better understanding of the sun’s effects on skin, they recommend wearing sun protection every day on any exposed areas, even when it is cloudy or in winter. This is particularly important if you spend a lot of time outdoors.  

• The sun has an accumulative effect over time. The more skin is exposed to solar radiation, the weaker its natural defence and repair mechanisms. Damaged DNA may not fully recover, which gradually increases the risk of skin cancer. To reduce the impact, it is essential to apply sun protection daily.

• Photoderm XDefense Ultra-fluid SPF50+ Invisible offers broad-spectrum protection from long and short UVA rays, UVB, infrared and visible light. 
• Developed by Bioderma, Photoderm XDefense Ultra-fluid SPF50+ Invisible is also the 1st detox suncare for cellular protection that treats air pollution as an aggravating factor during sun exposure. Like UV rays, indoor & outdoor pollution increase oxidative stress leading to accelerated photoaging.

Wear sunglasses

As well as leading to sun-damaged skin, UV rays may also affect your eyes if you don’t wear sunglasses with effective filters. UVA and UVB rays can damage the cornea, lens and even retina leading to conditions such as:

• Keratitis, inflammation of the cornea
• Cataracts, premature aging and clouding of the lens
• AMD, aged-related macular degeneration 

Wear protective clothing

Clothes offer the best possible protection from the sun, particularly if you are outside for long periods. Wear trousers and a long-sleeve top made from light, natural, breathable materials. Choose a wide-brimmed hat that protects your neck and face, as well as sunglasses – applying sunscreen on any areas that are still exposed. 

Avoid the sun when UV rays are strongest

The intensity of the sun’s rays depends on where you are, the season and time of day. The stronger the radiation, the more dangerous it is for your skin – if it is not protected by effective sunscreen. You could check the UV Index, which measures the intensity of UV radiation in a particular location on a particular day. In general, it is best to avoid exposure between 10am and 4pm.

Can sun damage be reversed?

Sun-damaged skin can be improved with targeted care. Retinoids, vitamin C and AHA help reduce lines and wrinkles, as well as marks. You could also opt for chemical peels, laser or intense pulsed light treatments to repair sun-damaged skin – reducing hyperpigmentation and improving texture. However, the damage caused by solar radiation to DNA is irreversible. This is why it is so important to limit exposure and protect your skin every day with broad-spectrum sunscreen.

When should I see a dermatologist?

It is a good idea to consult a doctor or dermatologist if:

• Your sunburnt skin has blistered, or you have a high temperature 
• Your skin is bleeding, infected or very painful after sunburn  
• A mole or beauty spot changes colour, size or appearance
• You notice any new skin lesions with an unusual appearance

It is a good idea to get your skin regularly checked by a dermatologist to detect any problems or changes as early as possible.

Citations

[1] Prihadi, Ihsany Arafiasetyanto; Ellistasari, Endra Yustin; and Kusumawardani, Arie (2022) "The Difference In Transepidermal Water Loss (TEWL) Values Between Sun-exposed and Non-sun-exposed Skin Among Male Medical Students," Journal of General - Procedural Dermatology & Venereology Indonesia: Vol. 6: Iss. 2, Article 4.
DOI: 10.7454/jdvi.v6i2.1003

[2] Carine Jacques, Emilien L. Jamin, Anais Noustens, Christophe Lauze, Isabelle Jouanin, Gautier Doat, Laurent Debrauwer, Sandrine Bessou‐Touya, Eggert Stockfleth, Hélène Duplan, Multi‐omics analysis to evaluate the effects of solar exposure and a broad‐spectrum SPF50+ sunscreen on markers of skin barrier function in a skin ecosystem model, Photochemistry and Photobiology, 10.1111/php.14001, 101, 2, (373-385), (2024).

[3] Julia Benedetti, MD, Harvard Medical School - Rev. Karen McKoy, MD, MPH, Harvard Medical School, Coups de soleil - Nov. 2023

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[5] Flament F., Bazin R., Laquieze S. et al. – “Effect of the sun on visible clinical signs of aging in Caucasian skin.” Clinical, Cosmetic and Investigational Dermatology 2013 ; 6 : 221-232. DOI : 10.2147/CCID.S44686.

[6] UVA causes dysfunction of ETBR and BMPR2 in vascular endothelial cells, resulting in structural abnormalities of the skin capillaries

Miyachi, Katsuma et al. Journal of Dermatological Science, Volume 105, Issue 2, 121 - 129

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[8] Biskanaki, F.; Kefala, V.; Lazaris, A.C.; Rallis, E. Aging and the Impact of Solar Ultraviolet Radiation on the Expression of Type I and Type VI Collagen. Cosmetics 2023, 10, 48. https://doi.org/10.3390/cosmetics10020048

[9] Gromkowska-Kępka, K.J., Puścion-Jakubik, A., Markiewicz-Żukowska, R. and Socha, K. (2021), The impact of ultraviolet radiation on skin photoaging — review of in vitro studies. J Cosmet Dermatol, 20: 3427-3431. https://doi.org/10.1111/jocd.14033

[10] Guan, L. L., Lim, H. W., & Mohammad, T. F. (2021). Sunscreens and Photoaging: A Review of Current Literature. In American Journal of Clinical Dermatology (Vol. 22, Issue 6, pp. 819–828). Adis. https://doi.org/10.1007/s40257-021-00632-5

[11] Chen, J., Liu, Y., Zhao, Z., & Qiu, J. (2021). Oxidative stress in the skin: Impact and related protection. In International Journal of Cosmetic Science (Vol. 43, Issue 5, pp. 495–509). John Wiley and Sons Inc. https://doi.org/10.1111/ics.12728

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