Lifestyle Choices

This is a topic close to everyone’s heart. Many Western people are on the one hand increasingly conscious of their appearance and on the other hand doing irreversible damage to their skin by excessive sunbathing. Even sun- protected skin will age. Sunlight creates its own effect called photoaging, and the two processes together eventually lead to the typical changes of wrinkling, color variation and prominent blood vessels seen in old people who have spent much of their lives outdoors. We are now seeing this in younger individuals. Ultraviolet light and the changes it can effect will be discussed in detail, and then some of the theory behind skin aging and how to avoid it.

Ultraviolet light (UV)

Natural sunlight is made up of heat, visible light and ultraviolet light. The heat is essential for the warmth of our planet, the visible light for vision and photosynthesis in plants, but the ultraviolet is of less certain benefit. It does help to make vitamin D in the skin and insufficient can lead to rickets in children. Ultraviolet itself is divided into A (long-wave length), B (middle-wave length) and C (short-wave length which never gets through the atmosphere), but only the A and B are important here. They are abbreviated as UVA and UVB. The skin’s response to UV is generally a protective one. Sunburn is a response to injury and suntan is a more effective protection because the melanin pigment absorbs UV. In tropical countries human skin has evolved to brown or black as a protective medium.

The dose of UV received by an individual depends on a large number of variables such as distance from the equator, time of year, time of day, cloud cover, reflective surfaces. You could burn badly in ten minutes in the highest UV conditions. Height above sea level is relevant because UVB is absorbed in the atmosphere: at high altitude there is a lot more UVB. Below sea level there is very little UVB, which explains why people can stay out for so long at resorts on the Dead Sea. They get plenty of UVA but it does not burn skin as effectively as UVB.

Skin aging and photoaging

As the percentage of over sixty-five-year olds in the population increases, the nature of aging and the diseases which it brings become more important. In addition, most older people have cosmetically annoying problems and many are the direct result of sun exposure over a lifetime. Normal aging leads to a loss of elasticity with fine wrinkles and a tendency to various harmless tumors and build up of certain cells - e.g. seborrheic warts. This occurs despite the fact that overall the cells are dividing more slowly. Also the number of sweat glands and blood vessels and the amount of fat is decreased.

Photoaging is important because it leads to color variation, wrinkles, prominent blood vessels and a variety of tumors, some of which are serious. Ultraviolet directly damages the cells of both epidermis and dermis. Some repair occurs, but over a period of time these cells show permanent damage and produce poor-quality collagen in the dermis and abnormal development in the epidermis.

Skin changes due to ultraviolet

Short-term Sunburn

The main agent here is UVB. We are all familiar with the sight of a lobster-colored sunbather who has badly underestimated the sun’s intensity or the amount of scattered radiation. It appears from thirty minutes toseveral hours after exposure and starts with redness and a burning sensation. In severe cases swelling and blistering appears, reaching a maximum on the second day, and in that situation some headache, and fever are often present. It settles slowly and peeling is the last stage. There is no very effective treatment for sunburn, though wrapping the affected parts in water-soaked bandages is soothing.

Skin thickness

A few days after exposure the epidermis shows a slight increase in thickness and this may have a protective effect.

Pigmentation

The well-known suntan is the result of new melanin pigment in the epidermis which appears a few days after UVB exposure. It is an effective though not complete absorber of further UVB. People with the fairest skin may never tan but always burn. Most people redden a little before tanning but others never bum.

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