Photodamage

Photoaging and photodamage (dermatoheliosis) are terms used interchangeably to describe chronic changes in the appearance and function of the skin caused by... 

Photoaging and photodamage are serious medical problems, not just cosmetic or aesthetic concerns, because prevention of photoaging and photodamage may prevent the progression of changes toward skin cancer. 

Wondrak, G. T. Jacobson, M. K. Jacobson, E. L. (2006). Endogenous UVA photosensitizers mediators of skin photodamage and novel targets for skin photoprotection. Photochemical Photohiological Sciences, Vol.5, (nd), (August 2005), pp. 215 - 237, ISSN 1474-905X. 

In turn, an important factor that can damage DNA in nature or at performing molecular genetic studies, is ultraviolet (UV) radiation that is absorbed by this biopolymer at bandwidth maxmum 254 nm. This led to the formation of different DNA photodamages, with increasing of the dose of UV radiation progressed from pyrimidine dimers to single-and double-stranded breaks [Cariello et al., 1988 Lyamichev et al., 1990]. 

Fraikin, G., Strakchovskaya, M., Rubin, A. Light-induced processes of cell protection against photodamage. Biochemistry, Vol.65, No.6, (June 2000), pp. 865-875, ISSN 0006-2979... 

Minimal efficacy in patients with significant photodamage... 

Patients with photodamage can apply a lotion containing 25% glycolic acid for 6 months. In such cases an increase in total skin thickness of approximately 25% was reported, accompanied by an increased thickness of viable epidermis and dermis, an increased content of acid mucopolysaccharides, a greater collagen density and an improved quality of the elastic fibers. This could be defined as self-treatment. 

Gladstone HB, Nguyen SL, Williams R, Ottomeyer T, Wortzman M, Jeffers M, Moy RL (2000) Efficacy of hydroquinone cream (USP 4%) used alone or in combination with salicylic acid peels in improving photodamage on the neck and upper chest. Dermatol Surg 26(4) 333-337... 

Jessner s peels have been used to treat acne, melasma, post-inflammatory hyperpigmentation, lentigines, freckles, and photodamage (Figs. 3.2a,b, 3.3a, b and 3.4a, b). 

Fig. 4.11a, b. Photodamage with wrinkles and solar lentigo before and after peeling... 

Given these findings, indications for salicylic acid peels include acne vulgaris (inflammatory and non-inflammatory lesions), acne rosacea, melasma, post-inflammatory hyperpigmentation, freckles, lentigines, mild to moderate photodamage, and texturally rough skin. 

Fig.8.4 a,b. Idear candidate for deep chemical peeling middle-aged fair-skinned woman with blue eyes and blond hair and photodamage-induced wrinkling before (a) and after (b) deep chemical peel... 

The combination of salicylic acid and TCA 15% is also an effective treatment for mild to moderate photodamage, acne and melasma in types 1-111. Moderate to excellent improvement has been observed (Figs. 10.3a, b, 10.4a, b and 10.5a, b). Hence, the combination salicylic acid/TCA peeling protocol can be used in all skin types. 

Fig. 10.3. a Patient with photodamage of the chest, b Note significant improvement after combination salicylic acid/TCA peel... 

Peel indications differ between light and dark skin. Key indications in Fitzpatrick s skin types I-III include photodamage, rhytides, acne. 

In a histometric, immunohistochemical and ultrastructural study, TCA peeling in concentrations of 10,20 and 30% were compared with dermabrasion in nine dark-skinned patients (Fitzpatrick s IV and V) with photodamage [24]. Both procedures induced increasing amounts of types I and III collagen. However,... 

Historically, photoaging has been defined as the superimposed effects of photodamage on intrinsically aging skin. It is a consequence of chronic ultraviolet light exposure. Photodam-... 

Clinically, photodamaged skin is characterized by coarse and fine wrinkling, mottled pigmentary changes, sallowness, textural rough-... 

Fig. 15.2. a Biopsy of a 50-year-old Caucasian woman showing epidermal atrophy and collagen degeneration, b Biopsy of a 50-year-old African American woman showing minimal to no evidence of photodamage... 

---