The dark side of sun exposure

Basking in the warm glow of the sun can make us feel good. However, the cumulative effects of sun exposure put us at higher risk of cellular damage, early wrinkling, age spots, actinic keratoses and skin cancer - including malignant melanoma, the most serious type. Can you spot the effects of excessive sun exposure?

Suntan

Tanned skin may be revered as beautiful, but that golden colour you see is the result of injury to the epidermis, the top layer of skin. Exposure to the sun’s ultraviolet (UV) rays accelerates the effects of ageing and increases your risk of developing skin cancer. To prevent sun damage, use a sunscreen of SPF 15 or higher when outdoors and re-apply it regularly. Also, cover-up and seek the shade during the middle of the day.

Sunburn (first-degree burns)

Sunburn is skin damage from the sun's UV rays. Most sunburns result in redness, warmth to the touch, and mild pain, affecting only the outer layer of skin (first degree burns). Sunburn usually appears within hours after sun exposure and may take several days to weeks to fade. Painkillers such as paracetamol or ibuprofen, cold compresses and aloe, hydrocortisone or moisturising creams may help reduce pain and discomfort.

Sunburn (second degree burns)

A second degree burn - damaging deeper skin layers and nerve endings - is usually more painful and takes longer to heal. It's characterised by redness, swelling and blistering. If blisters form, do not break them - they're a source of moisture and protection. Breaking the blisters may lead to infection. Consider seeking medical attention if you have blistering sunburn.

Wrinkles

The sun's rays make skin look old and wrinkled years before it should. More than 80% of the signs of skin ageing in adults are the result of the tans they had as teenagers before the age of 18. That’s because over time, the sun's ultraviolet light damages the fibres in the skin called elastin. When these fibres break down, the skin begins to sag, stretch and lose its ability to go back into place after stretching.

Uneven skin tone

Too much sun also causes irregular colouring or pigmentation of the skin. Some areas of the skin appear darker, while others look lighter. The sun can also cause a permanent stretching of small blood vessels, giving your skin a reddish appearance.

Freckles

Flat, pigmented spots on the skin, freckles are usually found on sun-exposed areas of the body. They're more noticeable in the summer, especially among fair-skinned people and those with light or red hair. Freckles pose no health risk, but some cancers in the earliest stages resemble a freckle. Seek medical advice if the size, shape or colour of a spot changes or becomes painful.

Melasma (pregnancy mask)

Melasma (or chloasma) is characterised by tan or brown patches on the cheeks, nose, forehead and chin. Although usually called the 'pregnancy mask', men can also develop it. Melasma may go away after pregnancy. If it persists, melasma can be treated with prescription creams and over-the-counter products. Use a sunscreen at all times if you have melasma, as sunlight worsens the condition.

Age spots (solar lentigines)

These brown or grey spots are not really caused by ageing, though they do multiply as you get older. Age spots are the result of sun exposure, which is why they tend to appear on areas that get a lot of sun, such as the face, hands and chest. Bleaching creams, acid peels and light-based treatments may lessen their appearance. Solar lentigines are harmless, but to rule out serious skin conditions such as melanoma, seek medical advice to confirm the diagnosis.

Actinic keratosis (solar keratosis)

The small, scaly red, brown or skin-coloured patches caused by too much sun exposure commonly occur on the head, neck or hands, but can be found elsewhere on the body. Actinic keratosis usually appears on people after the age of 40, but they can appear in much younger people. People with fair skin, blonde or red hair, and blue or green eyes are most at risk. Early treatment is advised to stop the possible progression to squamous cell carcinoma, a type of skin cancer.

Actinic cheilitis (farmer’s lip)

Related to actinic keratosis, actinic cheilitis is a precancerous condition that usually appears on the lower lips. Scaly patches or persistent dryness and cracking of the lips may be present. Less common symptoms include swelling of the lip, loss of the sharp border between the lip and skin, and prominent lip lines. Actinic cheilitis may eventually evolve into invasive squamous cell carcinoma if not treated.

Squamous cell carcinoma

This non-melanoma skin cancer may appear as a firm red nodule, a scaly growth that bleeds or develops a crust, or a sore that doesn’t heal. It most often occurs on the nose, forehead, ears, lower lip, hands and other sun-exposed areas of the body. Squamous cell carcinoma is curable if caught and treated early. If the skin cancer becomes more advanced, treatment will depend on the stage of cancer.

Bowen's disease

Bowen's disease is also called squamous cell carcinoma "in situ." It is a type of skin cancer that spreads outward on the surface of the skin. By contrast, "invasive" squamous cell carcinomas can grow inward and spread to the interior of the body. Bowen's disease looks like scaly, reddish patches that may be crusted. It may turn into invasive squamous cell carcinoma.

Basal cell carcinoma

The most common form of skin cancer, basal cell carcinoma is the most easily treatable and least likely to spread, though it can damage surrounding tissue. Because basal cell carcinoma spreads slowly it occurs mostly in adults. Basal cell tumours can take on many forms, including a pearly white or waxy bump, often with visible blood vessels, on the ears, neck or face. Tumours can also appear as a flat, scaly, flesh-coloured or brown patch on the back or chest, or more rarely, a white, waxy scar.

Malignant melanoma

Malignant melanoma is not as common as other types of skin cancer, but it's the most serious and potentially deadly. Possible signs of malignant melanoma include a change in the appearance of a mole or pigmented area. Seek medical advice if a mole changes in size, shape or colour, has irregular edges, is more than one colour, is asymmetrical, or itches, oozes or bleeds. Malignant melanoma can affect the skin only, or it may spread to organs and bones. It can be cured if it's found and treated early.

Cataract

A cataract is a cloudy area in the lens of the eye that blocks the passage of light to the retina. Cataracts are painless but may cause vision problems, including foggy vision, glare from light and double vision in one eye. Reduce the risk of cataracts by wearing a hat and sunglasses when in the sun.

Shun the sun

The best way to prevent sunburn, premature wrinkles, skin cancer and other damaging effects from the sun is to stay out of it, especially between 11am and 3pm in the UK, when the sun’s rays are strongest. Apply sunscreen liberally (don’t forget the lips and ears!), wear a hat and sunglasses and cover up with clothing when outdoors. If you notice changes to your skin such as a mole changing appearance, a new growth, or a sore that won't heal, seek medical advice promptly.

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