6 medical tips to avoid skin blemishes in summer

Summer is here, a time to relax and enjoy the sun. But there is also concern about facial blemishes, which is why it is important to carry out our activities in the sun safely to avoid damage to our skin that could be aggravated in the future.

Most common summer spots: lentigines and melasma

There are many types of facial blemishes; therefore, in this article, we will focus on two types of dark spots that, due to their persistence and intensity, are very frequent in the aesthetic dermatology office: solar lentigines and melasma:

• Solar lentigines are brown freckles with a size between 3 and 10 mm, located in areas exposed to the sun such as face, neckline, external face of upper limbs and legs.
• Melasma or chloasma is that dark spot, wide and with irregular edges, geographical aspect, simulating a map that generally appears on cheeks, forehead and skin of the upper lip. The main triggering factor of melasma is the sun, however, there is a hormonal factor involved as evidenced by the fact that they are much more frequent in women, especially young and middle-aged women. This hormonal factor may be due to ovarian or thyroid hormonal alterations, pregnancy, use of contraceptives, among others. They are very dynamic and reappear easily.

6 steps to prevent summer facial blemishes

With the arrival of summer there is a greater intensity of ultraviolet (UV) rays and our skin is very exposed so we will discuss a set of appropriate measures to be taken to prevent or reduce the appearance and avoid worsening of these dark facial spots. With this objective we make the following recommendations:

1. Avoid the Sun: especially between 11:00 am and 4:00 pm, which are generally the hours of maximum UV index (high and/or extreme UV index), use of hat or pamela with wide brim and protective clothing, as well as try to be under the umbrella or in the shade.
2. Sunscreen use: Use a sunscreen with SPF preferably 50+, which also protects against UVA, high energy visible light (HEVL) and infrared (IR). This is known as a broad spectrum sunscreen. It should be applied every 2 hours and after every bath, since UV radiation is present as long as there is sunlight, so sunscreen should be applied daily.
3. Avoid tanning: It is essential to avoid sunburn, but not only this is enough to avoid stains and damage to the skin; you should also avoid tanning. There is no such thing as a safe tan since tanning always indicates skin damage.
   The above three measures are fundamental and without them it is not possible to avoid sun spots. However, there are other measures that, together with the above, can contribute to this objective. Among these we have:
4. Review cosmetics and medications for daily use, whether taken orally or applied to the skin: some medications can increase the skin’s sensitivity to the sun, i.e. they are photosensitizers. Also some cosmetics such as retinoids or perfumes. Therefore, in case of doubt, it is recommended to consult a dermatologist or pharmacist.
5. Use depigmenting substances for topical application: In pharmacies they can be found in creams, ampoules, serums or gels suitable for use in summer. The active ingredients in these products include azelaic acid, ferulic acid, arbutin, niacinamide, tranexamic acid, Kojic acid and topical vitamin C and are used with the intention of inhibiting pigment formation in addition to the antioxidant effect against solar radiation. Topical products of this type tend to be safe and although there are studies supporting the use of many of them, more rigorous and controlled efficacy studies are still lacking.
6. Dietary supplement-based treatments that are administered orally in capsules. Ingredients include Polypodium leucotomos extract, beta-carotene and carotenoids, vitamin E, oral vitamin C, polyphenols, melatonin and procyanidin. The mechanism of action of these products includes antioxidant, anti-inflammatory, ultraviolet radiation absorption and other effects. They provide an aid to topical sunscreens but do not replace them. Dietary supplements currently available in pharmacies contain some of these substances in different combinations and concentrations in a single product. There are studies and scientific reviews related to the efficacy and safety of these products, and there is still much room for research on this subject.

In case of doubt about the diagnosis or treatment of the spot you present, it is always important to consult a dermatologist.

• Zouh L and Bibergenova A. Melasma: systematic review of the systemic treatment. International Journal of Dermatology 2017;56:902-90.
• Rashmi Sarkar et al. Medical management of melasma: A review with consensus recommendations by Indian pigmentary expert group. IJD Symposium 2017;62(6):558-577.
• Juhasz MLW, Levin M K. The role of systemic treatments for skin lightening. J Cosmet Dermatol. 2018;17:1144-1157.