Educating your patients about sun damage
With summer on the horizon, it is understandable that patients will start wanting to make the most of the seasonal sunshine. And with Sun Awareness Week taking place this month from 6-12th May, now is the prime time to educate your patients about sun damage and sun safety.
While ultraviolet (UV) rays do have positive effects on the body, predominantly through the activation of vitamin D, they also have negative effects on the skin and can increase the risk of cancers and photoageing. As an aesthetic practitioner, it is important to be aware of the common signs of sun damage in your patients, provide available treatments for sun-damaged skin and advise patients how to stay safe in the sun.
Skin types can be categorised by measuring certain characteristics set out by Dr Thomas Fitzpatrick, who developed a classification system for skin based on its response to UV exposure and the degree of burning and tanning experienced. The Fitzpatrick skin type system specifies six skin types, ranging from type I, which is skin that never tans and always burns, through to type VI, which always tans and never burns. Type I is significantly more likely to develop a skin cancer in comparison to type VI, as Type I does not have the same amount of melanin in the skin as type VI. Melanin helps to protect the skin from the sun. As a practitioner, you should be able to identify what skin type your patient has and advise on how best to prevent sun damage accordingly – this article featured in the Aesthetics journal can help you understand how different types of skin react to the sun.
Signs of sun damage
1) Moles – The NHS describes moles as “small coloured spots on the skin.” Moles are extremely common and, according to the British Skin Foundation, most people in the UK have between 10 and 50. Moles can be flat or raised, however irregular enlarged moles may either indicate skin cancer or developing skin cancer. Skin cancer results from the uncontrolled growth of abnormal skin cells and can be caused by UV rays from the sun and tanning beds, or genetic mutations. There are several types of skin cancer – basal cell carcinoma being the most common type and melanoma the most serious.
One good way to advise your patients on identifying any cancerous moles is by using the ABCDE method:
A – Asymmetrical: normal moles are round in appearance and grow evenly so a mole that appears uneven and is asymmetrical should be investigated
B – Irregular borders: normal roles have smooth and clearly defined borders, moles of concern often have ragged or blurred borders or edges
C – Multiple colours: regular moles have a standard uniform colouration. Melanomas can have two or three different shades of brown, black, red and pink
D – Diameter: moles that are bigger than a pencil eraser should be investigated
E – Evolving: changing, or new, melanomas often change in size, shape and colour over time and can also become raised above the skins surface. Any inflammation or swelling should also be investigated.
Moles can either be removed by laser removal or excision, depending on the size and shape of the mole. If in any doubt then patients should be encouraged to seek professional advice from their GP. Find out more about the ABCDE of moles here.
2) Sunspots – are flat areas of skin discoloration that can be varying shades of brown. They appear on parts of the body that get the most sun exposure, such as the face, shoulders and back. They are noncancerous and do not pose any risk to patients’ health or require treatment unless a patient is looking to remove them for cosmetic reasons.
Laser resurfacing, intense pulse light (IPL), cryotherapy and skin peels can help to remove sunspots.
3) Melasma – is another common skin problem that affects areas that get a lot of sun exposure, including the forehead, cheeks, nose, and upper lip, often causing brown or grey-brown patches on the skin. Melasma typically appears as symmetric, blotchy hyper-pigmented patches and, although non-cancerous, can be an aesthetic concern for many patients.
Although melasma cannot be cured, there are treatments which can help, including laser, chemical skin peels and topical skin-lightening products.
4) Photoageing – too much sun exposure can cause premature ageing of the skin and is known as photoageing. Photoageing can cause coarse, dry and leathery skin, freckling and skin discolouration, and deep wrinkles.
For early signs of ageing, treatments that use retinoids, vitamin C, and alpha hydroxy acids may be enough. However for moderate to more severe facial sun damage, chemical peels, dermabrasion or laser resurfacing may be an option. Deeper facial lines can be treated with botulinum toxin or hyaluronic acid dermal fillers.
If you notice that your patient has sun-damaged skin, it is your responsibility to mention it to the patient. In addition, you should also try to advise all patients of the importance of sun safety. There a number of ways in which you can advise them to keep their skin safe in the sun:
- Be sure to always talk to your patients about using sun protection, including the importance of using a good quality SPF sunscreen (that counters both UVA and UVB rays) during the consultation
- Remind patients to spend minimal time in the sun. Although many people love to sunbathe during the summer months, UVA rays, which cause the most damage, are present throughout the whole year and can pass through clouds and windows, so patients should be diligent year round
- Always ask your patients if they have noticed any skin changes, particularly moles. If there are reported changes in shape, size, number or colour, it is vital that they are referred to a dermatologist for mole removal if necessary
- Be mindful of the time of year that patients are seeking cosmetic procedures. Some patients undergoing procedures will need to stay out of the sun for a period after the initial treatment, so it would not be advised for a procedure to take place if the patient is due to be taking off for a long summer holiday. In addition, some ingredients in products used during cosmetic procedures can increase skin sensitivity; this includes acetic acid and retinoids and in instances where patients have undergone treatments involving these products they should stay out of the sun
- Include after care information related to sun exposure for your patients, as this can help to educate and remind patients about how to look after their skin in the sun following their treatment and prevent any further sun damage
- For more top tips on advising patients to stay safe during summer time, read our article
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