Photoaging

desquamazione, cheratosi attinica, fino ai tumori della pelle.
Photoaging is a form of skin aging due to the chronic damage caused by ultraviolet rays and sun exposure. Over time, sun exposure causes serious damage to the DNA of skin cells and prematurely ages the skin, in addition to ongoing biological aging. Regular and repeated sun exposure damages the skin’s collagen supply, resulting in: deep and widespread wrinkles, loss of elasticity, dry, rough skin, presence of dilated capillaries on the cheeks, nose and ears, sunspots, scaling, actinic keratosis, and
the increased risk of skin cancers.

Description

The dermis is an organ that is continuously developing. In adolescents and young adults, there is a fine balance between the synthesis of new collagen (the main protein of connective tissue) by fibroblasts, and the degradation of collagen by certain molecules. This mechanism is accelerated by profound changes in fibroblast activity that alters the recovery of collagen, ultimately leading to a more rapid aging process of the skin. Ultraviolet radiation (UVB and UVA) are among the main contributors to premature skin aging and the chronic damage caused by UV radiation is called dermatoheliosis. These skin changes take place prematurely in many adults and are in addition to the changes caused by natural physiological aging. This phenomenon is increasingly prevalent among adults today, due to the aesthetic appeal of tanned skin and the subsequent exposure to tanning lamps or the sun, combined with a lack of awareness of the damage that UV rays cause the skin, including the increased risk of cancer. Indeed, the risk of cancer is directly proportional to the degree of photoaging.

Causes

Ultraviolet radiation, whether from the sun or from tanning lamps, causes damage to skin structures, increasing the oxidative process and instability of skin cells, as well as causing damage to DNA. This results in profound changes in cells and an instability in the turnover mechanism of connective layers, with imbalanced collagen production and the replacement of damaged connective fibers.
Oxidative stress, which can be induced by smoking and pollution, is another cause of collagen metabolism imbalances that accelerate skin aging processes.

Symptoms

The most common and rapidly appearing signs of premature skin aging are:

• more extensive, deeper wrinkles
• loss of tone and elasticity
• thinning of the dermis
• loss of firmness
• dry skin
• ephelides
• sun spots (brown, dark gray or whitish) and otherwise altered pigmentation
• actinic keratosis
• dilation of blood vessels
• tumors of the skin

Diagnosis

Photodamage can lead to cosmetic as well as systemic consequences, and therefore, symptoms need to be evaluated carefully. The first step is an examination, in which visible damage is analyzed by a dermatologist. From here, any subsequent dermatopathology tests are prescribed, which may include biopsies to examine specific skin samples.

Treatment

Treatment of photoaging reverses the progression of the oxidative processes which have led to the breakdown of collagen. Another important goal of treatment is to eliminate potentially cancerous cells.
Treatment options may include:

• use of topical tretinoin
• photodynamic therapy (PDT)
• micropeeling with alpha and beta hydroxy acids
• collagen stimulation with needling

Prevention

Prevention of photoaging includes: limiting sun exposure; avoid the sun during the middle hours of the day when the rays are at their most intense. Protect exposed parts of the body (head, face and hands) with clothing or use natural mineral light reflectors on skin that remains exposed. Avoid the use of tanning lamps and sunbeds, following a healthy lifestyle, with a diet rich in fruits and vegetables, drinking plenty of water and do not smoke.