ABOUT AGING SKIN (continued)

Intrinsic aging is also affected by changes in your body chemistry over time, as well as changes in the skin's life cycle. The effects of intrinsic aging alone are subtle -- primarily skin laxity (looseness) and fine wrinkling -- and can most easily be detected in areas of skin not exposed to the sun.

Superimposed on these subtle changes in sun-exposed skin areas are changes due to extrinsic (environmental) influences, primarily "photodamage", skin damage caused by chronic exposure to ultraviolet radiation (UVR).

Photodamage is a cumulative process that takes place gradually over decades with little early clinical evidence. It begins with a child's first exposure to sunlight and accumulates throughout life with each additional exposure, whether prolonged or incidental. Eighty-five percent of what we think of as aging is actually caused by exposure to the sun.

Visible Signs of Photodamage
Erythema (inflammation), sunburn and tanning are acute reactions that occur within hours and days of exposure. Chronic photoaging occurs over many years of UVR exposure and is characterized by skin roughness, mottled hyperpigmentation (i.e., brown spots), fine and coarse wrinkling, sallowness, looseness of the skin, freckles and telangiectasia (a visible network of enlarged and broken superficial blood vessels). The severity of these signs tends to increase with the cumulative amount of sun exposure.

Prevention
Skin damage due to the sun can be reduced by adopting a comprehensive program of skin care. The most important step is to minimize sun exposure by avoiding outdoor activities at midday and by wearing protective clothing, specifically, hats and tightly knit, dry clothes. In addition, application of a sunscreen to all exposed skin (including the lips) with a sun protection factor (SPF) rating of 15 or higher affords significant protection from ultraviolet radiation (a waterproof sunscreen should be applied before swimming).

Treatment
In general, the public regards the problem of aging skin as a cosmetic problem. A significant portion of the more than $20 billion spent annually in the United States on cosmetics is specifically intended to improve or conceal damage caused by the sun. In addition, the number of cosmetic and plastic surgery procedures performed each year has grown rapidly.

In contrast, the medical community understands that overexposure to ultraviolet radiation causes not only visible displays of skin aging, but skin cancer as well. Therefore there is a need for medical intervention to protect, prevent, and treat.

"Most people have little understanding of how important prevention can be in delaying the signs of aging," explains Patricia Farris, M.D., a dermatologist and Assistant Clinical Professor, Tulane University School of Medicine, Department of Dermatology. "They persist in sunbathing with little or no protection and begin a protective regimen only after photodamage has become apparent. When it comes to treatment, they are confused by cosmetic counter promises of younger, healthier-looking skin."

Dr. Farris recommends talking to a dermatologist about skin care concerns and needs. "There are a number of options available, including medically proven breakthrough treatments available only from a dermatologist," she says. "A dermatologist can work with you to find a daily skin care regimen that addresses your individual skin type and fits your lifestyle."

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