You’ve probably been told over and over that too much Sun exposure will “age” your skin resulting in fine lines and wrinkles and may even lead to skin cancer. But what is going on beneath the surface of your skin to cause the visible lines and wrinkles? What is being damaged or destroyed and is it visible to the Pathologist under the microscope?
In the photo above, you see a section of skin at high magnification and stained with a special stain for elastic called EVG or Verhoeff Van Gieson. In this stain, elastic fibers appear black to blue/black, while collagen appears red. For orientation, the upper or outer layer of the skin called the epidermis (1) appears as a red band with the topmost keratinized or cornified layer having a loose basket-weave appearance (2). Below the epidermis is the dermis which is normally filled with plump red connective tissue fibers composed of collagen. In healthy skin, the entire dermis would be red, however this skin is severely sun-damaged, and the healthy red collagen has been nearly entirely replaced with abnormal ropey, irregular black elastic fibers (3). These elastotic collagen fibers are thinner and more fragile than normal collagen and do not offer enough volume or support to the epidermis for a smooth skin surface.
How does the Sun affect collagen resulting in what we call “solar elastosis”? Simply put, the ultraviolet radiation contained in the Sun’s rays can break down collagen and normal flexible elastin which is replaced by the abnormal black elastic fibers which you see above. This is the body’s way of compensating for the damage. On the molecular level, ultraviolet radiation can cause damage to the cellular DNA, which, if not repaired, can predispose one to skin cancers.
Some Sun exposure is essential to good health, particularly to produce Vitamin D and for overall well-being; however, repeated extensive exposure to Ultraviolet radiation and sunburns will lead to this type of damage especially in people with less melanin in their skin.
Prevention is key to having smooth healthy skin, but what if the damage has already been done? Some non-surgical strategies which are helpful are the use of retinol creams (which are clinically proven to increase dermal collagen), supplementation with collagen peptides, and red light therapy.
Dr Culton MD