Hyperpigmentation due to sun damage (photoaging) is a common concern that makes some patches of skin look darker than others. This darkening occurs when excess melanin deposits in the skin. Sun exposure is the number one contributing factor to excess melanin production. The sun stimulates melanin production, causing excess coloration to appear as patches on the skin. This condition is commonly called age spots or liver spots and can appear anywhere on the body or face. Hyperpigmentation due to sun damage can affect people of any race or ethnicity. However, the effect is more pronounced in a few ethnicities, such as Asians, Mediterranean, African, and Latin. Photoprotection is paramount to the treatment of this condition.
What is Sun Damage
Hyperpigmentation ('Hyper' means 'excessive', 'pigmentation' means 'coloration') is a chronic skin condition that makes some areas of the skin look darker than others. Hyperpigmentation typically manifests as black, brown, grey, red, or pink spots. These spots are sometimes called age, liver, or sun spots.
Hyperpigmentation disorders are largely benign and can occur in any area of the body, to people of any ethnic background at any age. However, the problem is more common and severe in darker-skinned individuals. The darker the skin color, the more intense and persistent hyperpigmentation tends to be. There is no gender difference.
Skin gets its color from a naturally occurring substance called melanin. Skin cells are responsible for producing melanin. When skin cells are damaged by sun exposure or other intrinsic or extrinsic factors, they tend to produce too much melanin. Excessive melanin can clump, making the skin look darker. Excessive sun and UV exposure are the primary contributing factors to the formation of excess melanin.
Photoprotection and protective sunscreens against UV radiations and visible light are recommended as first-line treatments. Other treatment modalities include topical creams, clinical therapies, chemical peels, and light-based therapies. Biological differences among richly pigmented skin need additional consideration when deciding on treatment and management.
Common Types of Sun Damage (Hyperpigmentation)
Sun damage (hyperpigmentation) can cause premature skin aging, such as wrinkles, fine lines, age spots, and more serious skin conditions. By understanding the different types of sun damage, individuals can take proactive steps to protect themselves from the sun's harmful rays, including wearing protective clothing, applying sunscreen regularly, and avoiding prolonged sun exposure during peak hours. Common types of sun damage (hyperpigmentation) are:
Sunspots or Age Spots
Age spots are small, flat, and dark areas on the skin. They may look like cancerous growths. However, they do not need treatment. They are signs that your skin has been significantly exposed to the sun.
Age spots vary in size and usually appear on areas of the body exposed to the sun, such as the face, hands, arms, and shoulders. Age spots are also called liver, sun, and solar lentigines.
Protection is the key to avoiding the risk of developing sunspots. Various non-invasive treatments can also lighten or remove age spots. Treatment options include topical creams, cryotherapy, microdermabrasion, dermabrasion, laser and intense pulsed light therapies, and chemical peels.
Melasma is a common type of skin hyperpigmentation caused by brown to gray-brown patches on the face. It mostly appears on the cheeks, chin, forehead, nose bridge, and above the upper lip. It is more prevalent in women than men.
Melasma is primarily attributed to ultraviolet (UV) exposure. Photoprotection is the first-line treatment of melasma. In addition to that, there are promising new treatments, including topical, oral, procedural therapies, or combination treatments.
Procedural therapies involve chemical peels, micro-needling, microdermabrasion, and lasers, typically in conjunction with other treatment modalities.
Treatment efficacy can vary due to several factors, including response to treatment amongst different genders, skin types, and ethnicities.
Freckles, the lay term for ephelides, is a common type of hyperpigmentation observed in humans. They are large pigmented spots associated with an increased risk of skin cancer. They are largely genetically determined but triggered by sunlight.
Different treatment modalities include home remedies, chemical peels, laser treatments, topical fading creams, topical retinoid creams, cryosurgery, and sunscreens. Sun protection doesn't help treat the existing freckles but prevents the development of new ones.
Among laser treatments, Erb: YAG laser is an effective treatment option for freckles using a single treatment session, which carries less risk and shorter downtime than CO2 lasers.
What Causes Sun Damage (Hyperpigmentation)
Sun damage (hyperpigmentation) is a common problem affecting millions worldwide. Sun damage can occur in anyone, regardless of age or skin type. It is particularly problematic for those who spend much time in the sun without adequate protection. Understanding the causes and effects of sun damage is crucial for maintaining healthy skin and preventing long-term skin damage:
Exposure to the sun's ultraviolet (UV) rays
Exposure to UV rays triggers melanin production in the skin, leading to uneven pigmentation and dark spots. To prevent hyperpigmentation, it is essential to protect the skin from UV radiation by using sunscreen, wearing protective clothing, and avoiding prolonged exposure to the sun.
Repeated sunburns or excessive sun exposure
The sun is the number one cause of skin hyperpigmentation. Among women, female sex hormones estrogen and progesterone stimulate the overproduction of melanin (a naturally occurring substance in the skin whose excess makes the skin look dark) when exposed to the sun. Sun protection is the key to preventing the development of sun spots and hyperpigmentation.
Not wearing protective clothing or sunscreen
Not wearing protective clothing and sunscreen can increase the risk of developing hyperpigmentation. The skin is more susceptible to UV damage and hyperpigmentation without adequate protection. It is important to wear protective clothing, such as hats and long-sleeved shirts, and to use a broad-spectrum sunscreen with a high SPF to minimize the risk of sun damage and hyperpigmentation.
Certain medications or medical conditions that make skin more sensitive to sunlight
Some medications, such as certain antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), and chemotherapy drugs, can make the skin more sensitive to UV radiation, triggering hyperpigmentation. Medical conditions such as autoimmune diseases, hormonal imbalances, and liver disease can also affect the skin's sensitivity to sunlight and increase the risk of hyperpigmentation. If you are taking medicines or have a medical condition that affects your skin's sensitivity to sunlight, you should practice extra care to protect your skin from the sun, such as wearing protective clothing and using sunscreen.
Procedures That Remedy Sun Damage (Hyperpigmentation)
There are several procedures that can help reduce the appearance of hyperpigmentation caused by sun damage. These procedures target the damaged skin cells and promote the growth of new, healthy skin cells, resulting in a more even complexion.
Explore some of the most effective procedures for treating sun damage and hyperpigmentation.
Chemical peelsFind doctors who offer Chemical Peel
Chemical peels work by removing the epidermal cells containing excess melanin. Caution must be practiced while administering these agents. They must be used by experienced clinicians as they can cause various side effects ranging from mild skin irritation to more serious adverse effects such as scarring, infections, and unwanted pigmentary shifts. Glycolic, salicylic, and trichloroacetic acid peels are common.
MicrodermabrasionFind doctors who offer Microdermabrasion
Microdermabrasion can help reduce the appearance of hyperpigmentation by removing the outer layer of skin where the pigment is most concentrated. It involves using a special device to exfoliate the top layer of the skin, removing dead skin cells, and promoting the growth of new, healthy skin cells.
The procedure is relatively painless and requires no downtime, making it convenient.
Laser therapy is an extensively studied treatment modality for sun damage (hyperpigmentation). Multiple laser types, including Q-switched ruby lasers, Q-switched Nd: YAG lasers, and picosecond (short, intense pulse) lasers, can be used to treat hyperpigmentation. However, experienced clinicians should also use them cautiously as they can cause skin irritation and additional hyperpigmentation.
Frequently Asked Questions
What are the symptoms of sun damage?
Some common symptoms of sun damage include:
Sunburn: This is the most common and visible symptom of sun damage. Sunburns cause redness, pain, and peeling of the skin.
Dry or Flaky Skin: Prolonged sun exposure can cause dryness or flakiness of the skin, especially in areas such as the face, arms, and hands.
Wrinkles: Sun damage can also cause premature aging of the skin, leading to the formation of wrinkles, fine lines, and age spots.
Uneven Skin Tone: Sun damage can cause uneven skin tone, with some areas appearing darker or lighter than others.
Skin Cancer: Prolonged sun exposure can increase the risk of developing skin cancer, such as melanoma o... Show more.
What treatments are available for hyperpigmentation caused by sun damage?
Some of the most common treatments for sun damage (hyperpigmentation) include:
Topical treatments: Topical treatments include creams, gels, or serums that contain ingredients like hydroquinone, retinoids, azelaic acid, or kojic acid. These products reduce the production of melanin, the pigment that gives color to the skin.
Chemical peels: This treatment involves applying a chemical solution to the skin, which exfoliates the top layer and stimulates the production of new, healthy skin cells.
Microdermabrasion: This non-invasive procedure uses a special device to remove the outer layer of the skin, which can he... Show more.
How can I treat sunburned skin and prevent further damage?
Treating sunburned skin involves soothing the affected area and preventing further damage. Avoiding further sun exposure is necessary, especially during peak hours, to prevent further damage. Wearing protective clothing like long-sleeved shirts, hats, and sunglasses and applying a broad-spectrum sunscreen with an SPF of at least 30 can also help prevent sunburn and further damage.
Can I still get sun damage on cloudy days or through windows?
Clouds can block some of the sun's visible light but don't block the harmful ultraviolet (UV) rays that cause sun damage. The UV rays can reflect off clouds on cloudy days and be even more intense than on a clear day, making it easier to get sunburned.
Similarly, glass windows can block UVB rays, responsible for sunburn, but don't block UVA rays, which can penetrate deeper into the skin and cause long-term damage. It means that even if you're inside or in a car with the windows up, you can still be exposed to UVA rays and experience sun damage.