Sun Damage Restoration
Sun damage can lead to redness, brown spots, uneven skin tone and texture, precancerous sunspots (actinic keratosis) and eventually skin cancer.
Sunspots occur particularly in areas that are exposed to the sun, such as the face, hands, and arms and sometimes on the lower legs. Given that a proportion of sunspots will develop further, it is vital that the spots be thoroughly monitored, to prevent their transition to cancer.
Causes of sunspots:
Sunspots more commonly occur in fair-skinned people who have had long term sun exposure. They can also be seen in people who are immunosuppressed, such as organ transplant patients and those on certain medications, such as prednisone.
The Skin Company approach:
Dermatologists sometimes refer to “field damage”. This means that the entire field of the skin is damaged by the sun, which is characterised by visible and non-visible microscopic damage. Our desire is to treat both.
There are many topical medical creams for sun damage. These all have pros and cons, but will not improve the other elements of sun damage such as redness, dilated capillaries, skin textural effects, and brown spots. If improvement of these elements is desired, a combination of medical and energy-based device treatment is required.
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Sunspots (also known as actinic keratoses or solar keratoses) are precancerous spots that occur on the skin with sun damage. They occur in sun-exposed areas such as the face, hands, and arms and can also occur on the lower legs, especially in New Zealand.
We do not know exactly how many of these will turn into cancerous conditions but we believe around 10-15% will progress. It is for this reason that it is important to have good control of sunspots to prevent their transition to cancer.
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Your treatment of sunspots will depend on how many you have and this will be assessed at the time of the full skin examination. If you have a few scattered spots, then the first option of treatment is with dry ice. This is also called cryotherapy and is a treatment used by a doctor in a spray form. It feels like a flick to the skin, at the time of treatment. The area then becomes red and swollen and a crust will form. Over the next week or two, this will slough away.
If you have a number of sunspots then field treatment can also be considered. This allows treatment of many spots at one time. There are a few ways that this can be performed, which include: topical 5-FU (Efudix), topical Imiquimod (Aldara) and also photodynamic therapy. You may choose to treat only a small area such as your nose or forehead, however more often a full face treatment is required and performed.
Pre-Cancerous Sunspots or Actinic Keratosis:
The Skin Company Treatment Options:
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Photodynamic therapy (PDT) is a very effective in-clinic treatment for patients with widespread sun damage. It uses red light along with chemicals known as photosensitizers, to treat pre-cancerous issues, certain superficial cancers and other conditions. This in-clinic treatment is associated with redness and swelling, typically peaking at 72 hours, followed by peeling, which resolves over 7-10 days.
The treatment may be painful, particularly at the time of light activation. Usually, only one treatment is needed, but your dermatologist may advise two treatments if you have a relatively severe occurrence of sunspots. If this is a treatment option for you, one of our clinic nurses will discuss this further with you. If you have had previous cold sores you will require anti-viral cover for those areas.
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This is a topical chemotherapy cream that is used daily to twice daily over a period of 2-3 weeks. The area becomes quite red and crusty initially, but then can lead to good control of the sunspots.
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This is a combination chemotherapy and Vitamin D cream that is used daily to twice daily over a period of 4-7 days. Treatment is discontinued when the area becomes red and crusty. It can be repeated 3 and 6 week later if scale persists. It is associated with shorter downtime than conventional Efudix therapy
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This works in a slightly different way, by stimulation of your Toll 7 receptors and is used 3-5 times a week for 4-6 weeks. The effects with redness and crusting are very similar to other treatment options for this concern. In 1-3% this option may be associated with flu-like symptoms, at which stage the treatment would be discontinued.
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Red brown colour changes (dyschromia) are best managed with energy based and laser devices such as BBL and MOXI. The importance of year-round daily SPF50+ broad spectrum sunscreen will be emphasised. Optimising skin care with topical anti-oxidantss ( ABC of skin care) will be discussed. The use of oral B3 antioxidant in skin cancer and sun spot prevention will be discussed.