Dr. Vilata is a renowned specialist in Dermatology in Valencia who in this article explains how to avoid premature skin aging. He also gives the keys to differentiate between benign and malignant lesions.
One of the most frequent consultations in dermatology clinics are the changes produced in the skin due to the passage of time and the action of the sun. These lesions are of concern to patients due to the social, aesthetic and even psychological aspects they entail, and they usually appear after the age of 40 or 50.
It is much more important to take care of them from a health point of view because of the possibility of finding cancerous lesions, which are of high incidence in sunny countries.
Care to avoid skin lesions
Advances in medicine together with the increase in healthy habits such as a good diet, moderate exercise and other factors that promote health have led to an increase in population and life expectancy in both women and men in the last 25 to 30 years in Western countries.
It is logical that the skin, the most external organ of the human body, has suffered many external aggressions over the years due to environmental changes (sun, wind, cold, environmental pollution) and other factors such as heredity, poor nutrition, occupational aspects and smoking, fundamentally.
For this reason, the skin must be taken into account and constantly monitored so that the first signs of aging do not turn into future precancerous and cancerous lesions in which the fundamental cause is the sun that has been taken indiscriminately for many years, in addition to the factors mentioned above.
Skin aging
The skin, even over the years, undergoes an intrinsic aging process (inexorable passage of time) like any other organ of the body. All organs age progressively, decreasing their functioning in unison and increasing their capacity to become ill. There is really a general progressive deterioration that manifests itself more in some people than in others. This deterioration causes environmental factors to affect the skin much more and accelerates the process of suffering various lesions, some benign and others malignant.
Therefore, two aspects can be observed in the deterioration of the skin: intrinsic aging and “photoaging” due to the action of the sun’s rays throughout life (chronic sun exposure), generally indiscriminately, including artificial ultraviolet radiation from cabins. The reflection of the sun’s rays from water, sand, white walls or surfaces and snow must be included.
Not only the action of the rays, but also the color of the skin, is a very important factor in photoaging. People with very white skin tend to always get sunburnt and find it much more difficult to get a tan. People with red hair and fair skin suffer much more skin lesions over the years. And more so in areas such as the face, décolleté, shoulders, arms, legs, etc., depending on the most exposed areas.
Clinical manifestations of photoaging
The clinical manifestations of cutaneous photoaging that appear on exposed skin are multiple. Among the benign ones are:
– Wrinkles: which can be observed very fine and as furrows sometimes very deep.
– Skin dryness (xerosis): very frequent and usually seen on the back of the legs and arms. It is important to apply moisturizers frequently.
– Skin atrophy (thinning): appears in very sun-damaged areas.
– Small arterioles (telangiectasias): they are observed by transparency of the thinned skin and the capillaries are also dilated. They are very frequent on the face, décolleté and lateral sides of the neck.
– Solar lentigines (hyperpigmented spots or macules): single or multiple, smooth to the touch and circular or oval in outline.
– Irreversible diffuse hyperpigmentation: it can be called “perpetual tanning”. It is very frequent and is observed in uncovered areas such as the décolleté, face, arms and legs. It is recognized because there has been chronic sun damage.
– Hypomelanosis in drops: multiple spots, acromic (without pigment), oval with a small diameter (4 or 7mm) very frequent on the back of legs and forearms. Sometimes they are accompanied by spots with pseudocicatricial aspect and stellate morphology.
– Comedones: they can also appear in the malar regions in adults.
Malignant lesions on photodamaged skin include the following:
– Actinic keratoses: lesions that are scratchy to the touch with detachment of scales/crusts with certain periodicity and that will evolve to squamous cell carcinoma with different signs such as bleeding, ulceration and potentially probability of metastasis.
– Basal cell carcinoma is the malignant tumor with the highest incidence and develops on skin without previous lesion, with the appearance of a nodular, shiny, pearly lesion. Its malignancy is local so it must be treated so that it does not affect other nearby areas.
Malignant melanoma is the most dangerous malignant tumor and in its evolution it can metastasize to lymph nodes and viscera ending the life of the person. Although there are different clinical varieties of this tumor, as a general rule it is characterized by a very black lesion with a nodular appearance or with an appearance that extends superficially or as a slightly elevated spot, although it can have different shades of color close to black.
The areas most affected by this tumor are the back, nape of the neck, chest, legs and abdomen, but it is important to regularly monitor the entire skin surface (including palms and soles) and see a dermatology specialist once a year.
Tips to avoid skin lesions
In people who have sunbathed a lot or have used ultraviolet radiation booths with a certain frequency, lesions similar to those described can be observed. They should consult a dermatologist to know the clinical diagnosis, which in many cases will require a biopsy (removing a small piece of the lesion) and sending it to the laboratory for confirmation. Your treatment will be carried out afterwards.
In case no worrisome lesions are found on your skin, but you have a marked affectation of the skin due to sun damage, you should periodically get in the hands of the dermatologist to try to minimize that sun damage and to recommend prevention rules so as not to add more damage to your skin.