By Dr. James Apesos


The boom in tanning centers and equatorial vacations are all indicative of our societal desires to obtain a suntan to darken pale light skin. Consequently you may be suffering from sun-damaged skin if you have spent years sun worshipping for a good tan.

Irrespective of warnings by dermatologist and plastic surgeons, people persist in obtaining as much sun exposure as possible, particularly early in their lives.  Blotchy skin wrinkles, and furrows are all due to aging skin, and sun-destroyed skin.

The most rational and sane recommendation is to avoid sunbathing and to use sunscreens.   Even if sun exposure is not anticipated a number 15 sun protection factor (SPF) or higher is best used daily.  Obviously sun exposure on a ski mountain causes excessive exposure and skin drying but office fluorescent lights will also cause damage. The SPF in products less than number 15 is usually not helpful enough and will not provide much sun blockage.  Additionally, a good moisturizer will help to keep your skin healthy.

What can you do about the permanent changes in your skin?  The most important problem may be formation of skin cancers.  Areas of crusting, ulceration, permanent changes in color and nonhealing areas should be looked at and biopsied by your dermatologist or plastic surgeon.

Basal cell carcinoma is most commonly seen across the forehead, dorsum of the nose and cheeks but can form anywhere.  These cancers often called rodent ulcers and are very slow to grow.  They can be easily excised and do not metastasize.

More aggressive lesions are the squamous cell carcinomas of the skin, these cancers can spread.  The lesions can present as small nonhealing areas and ulcerations of the face.

The most severe cancers which can be found on any part of the body are the black pigmented melanoma lesions.  Any lesion that changes color, enlarges in size, itches, changes to a blue or pink color, should be examined for biopsy as a possible melanoma.  These cancers are serious and can spread to the lungs, liver and brain.

People often want to reverse the effects of sun damage seen on aging skin.  The use of Retin-A (tretinoin) is helpful in minimizing small wrinkles and reversing the effects of sun damage changes in the skin.  Chemical peels remove wrinkling of the forehead, cheeks and mouth and remove brown discolorations.

Injectable fillers such as Juvederm, Artefil, and Sculptra are helpful to fill in lines and correct various aging changes. The most permanent method for facial rejuvenation is obtained using surgical techniques, including a forehead lift, face lift and upper and lower eyelid lift.  These procedures will remove excess skin and tighten muscles.

The most important first steps in preventing early aging and skin damage is to avoid excessive sunlight start using sunscreens and moisturizers at an early age.  Plus don’t smoke, watch the foods eaten, and avoid alcohol.

Dr. James Apesos, a clinical professor of plastic surgery at Wright State University School of Medicine, also has a cosmetic surgery practice in Dayton, Ohio