Photoaging is the ageing effect of ultraviolet (UV) rays upon the skin. This is characterised by increased or mottled pigmentation- particularly brown spots, wrinkles and the appearance of broken blood vessels. The skin can also take on a ruddy or yellow tone as well as feeling rough to touch.

 

At The Skin Hospital
There are many treatment options, depending on the nature of the skin changes and the skin type. Some treatments are not suitable for all skin types. Often, multiple treatment modalities are used together for the best result. The face, neck and chest are commonly treated. Discuss a tailored approach for your skin with your dermatologist.

General measures

  • Preventing further sun damage is an important step. Stay out of the sun when the UV rays are most intense and cover up with protective clothing. Frequent application of a high factor broad-spectrum sunscreen is crucial.
  • Smoking can lead to a yellowish discolouration of the skin, increased wrinkles and blackhead formation. Cessation of Smoking can improve skin quality.
  • Skin that has been exposed to high cumulative sun exposure is also more likely to develop skin cancer; a skin check by a dermatologist is advisable.

Medical therapies

  • Cosmetic creams: can help reduce the appearance of photoaging.
    • Over the counter products that contain Vitamin C and alpha-hydroxy acids can be of benefit.
    • Creams containing retinoids (vitamin A derivative) can be prescribed to smooth out roughness, fine lines and dyspigmetation in the skin.
  • Treatments for actinic keratosis (sun spots)
    • Various creams can be used to treat sun spots, which are pre-cancerous and cause skin roughness and scaliness. The type of cream and duration of use depends on how much damage there is to your skin (see actinic keratosis page).

Physical therapies

  • For fine lines and wrinkling
    • Muscle relaxant injections - Botulinum toxin (Botox or Dysport). This is injected in to the skin using a very fine needle.  Areas such as horizontal forehead lines, frown lines and crow’s feet can be readily treated. The injections work by preventing nerve impulses from triggering muscle contraction. This is a temporary treatment and to maintain the effect, injections are usually required every 3-4 months.
    • Dermal Fillers. These are injected under the skin to reduce hollowing, furrows and wrinkles & plump up the skin. Fillers are not permanent, therefore injections may need to be repeated to maintain the appearance. The frequency depends on the product used. Hyaluronic acid fillers will need to be repeated every (3-12 months) to maintain the appearance.
    • Fractionated laser (Pearl fractional). This exposes only a portion of skin to the laser beam, making the recovery faster than from fully ablative laser. Beams of laser penetrate deeper than non-fractionated laser, which stimulates the collagen underneath the skin and causes plumping of the skin over 3 months.
    • Ablative laser (Carbon dioxide/ Erbium). This can result in good improvement of fine lines and wrinkles; however the recovery period is longer. Topical anaesthetic and sometimes regional or general anaesthetics are used to reduce procedure-related pain. This is not suitable for some patients.
    • Intense pulsed light (IPL)/ broadband light (BBL). IPL/BBL uses flashes of visible light. Often a course of 3-4 treatments are required, with a 4 week break in between. Maintenance therapy can be used and has shown to keep the skin looking younger. This is more effective for facial redness and pigmentation than wrinkles.
  • For pigmentary changes: variable or increased pigmentation, freckles and lentigos – brown spots.
    • Intense pulsed light (IPL)/ broadband light (BBL) (see above).
    • Pigment laser. Certain lasers are effective at clearing brown pigmentation. The type of laser used depends on your skin tone and the type of pigmentation.
    • Fractionated non-ablative laser. This can be very helpful for brown pigmentation, which peels off over a week or two after treatment.

 

  • For broken blood vessels and redness.
    • Vascular lasers (nd-Yag, VBeam).  Vascular laser is helpful for treating blood vessels on the face and legs, as well as venous lakes and cherry angiomas. Some are also helpful for generalised redness and rosacea as well.
    • Intense pulsed light (IPL)/ broadband light (BBL). This is effective for generalised redness and also rosacea.
  • For rough skin
    • Ablative laser (Carbon dioxide/ Erbium) (see above)
    • Fractional laser (Pearl fractional) (see above)
    • Chemical peels (TCA or glycolic acid peels). These can be used to remove the uppermost layer of cells. The skin takes 7-10 days to heal and may appear a little red for weeks to months following the treatment.

 

  • For actinic keratosis (sunspots) and photorejuvenation
    • Photodynamic therapy (PDT) with IPL. This is a good treatment for sun damage, pigmentation and redness. It involves application of a photosensitising cream that is left on for 2-3 hours. After this, IPL is performed on the area, which activates the cream. The skin is often quite red afterwards, however usually heals in a week.

 

Dermatologists at The Skin Hospital to consult about cosmetic treatment for photoaging:

  • Dr Penny Alexander (Darlinghurst)
  • Dr Hanna Kuchel (Darlinghurst)
  • Dr Kavita Enjeti (Westmead)
  • Dr Tanya Gilmour ( Darlinghurst and Westmead)
  • Dr Rhonda Harvey (Darlinghurst )
  • Dr Sam Kalouche (Westmead)
  • Dr Shawn Richards (Westmead)
  • Dr Adrian See (Westmead)

Further information about photoaging and its treatments can be obtained from the following trusted sites:
http://dermnetnz.org/site-age-specific/ageing.html
http://dermnetnz.org/procedures/facial-rejuvenation.html
http://www.dermnetnz.org/procedures/implants.html

 

Authors: Dr Charlotte Thomas &, Dr Penny Alexander, last updated 3rd December 2015

 

Photoaging, Photorejuvenation and Cosmetic Treatments

Dr Rhonda A Harvey

Dr Harvey graduated with honours in medicine from the University of New South Wales in 1999. As part of her post graduate training,

Darlinghurst, NSW View details
Dr Penny Alexander

Fully qualified dermatologist working at The Skin Hospital

Dr Adrian See

Dr Adrian See graduated from Medicine from Sydney University in 1996, and worked at Wollongong and Westmead Hospital before successfully passing the Australasian College of Dermatology entrance exam…

Dr Shawn Richards

HEAD OF LASER SERVICES Chairman: SCFA Medical Advisory

Dr Tanya Gilmour

Dr Tanya Gilmour is a Dermatologist and Mohs

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