Photodamaged skin: a medical or a cosmetic concern?

A well-tanned skin is currently regarded as a sign of fitness, youth and health, with people increasingly exposing their skin to the sun and using tanning accelerators, such as psoralens, but exposure to ultraviolet B (UVB) radiation from the sun causes extrinsic ageing of the skin. The minimal erythema dose is rarely exceeded but the UVB dose that brings about irrepairable DNA damage leading to photodamage is lower. Growing numbers of patients, therefore, have prematurely aged skin with pigmented spots, dryness, itchiness and wrinkles. These symptoms are more than just of cosmetic concern. It is known that epitheliomas frequently develop in photodamaged skin; consequently, this skin requires medical treatment. Prophylactic measures should be taken from childhood, but an effective treatment for already damaged skin is topically applied tretinoin, which should be used with a mild skin cleansing and skin care programme.