It has been well-documented that UV exposure accelerates skin aging because free radicals initiate inflammatory cascades, which go on to cause cell and DNA damage. If normal skin needs UV protection, it follows that people with pre-existing conditions like rosacea and hyperpigmentation will need to take even greater precautions, as heavy sun exposure is known to aggravate them.
Indeed, too much sun can push previously normal skin into the “sensitized skin” category. Sensitized skin is less able to repair itself without showing signs of stress, and these stressors can show up as hyperpigmentation, melasma, rosacea or irritated skin and rashes of various types. I believe that the rising rates of these conditions can be attributed, at least in part, to the UV exposure connection. Let’s take a look at some common complaints.
Hyperpigmentation results from increased melanin production, which may occur in either the epidermis or dermis, or both. Three of the more common forms of hyperpigmentation disorder are lentigines, post-inflammatory hyperpigmentation and melasma.
Lentingenes are so-called liver spots or age spots. The connection between sun exposure and lentigenes is well established, as they appear in older people in the areas most heavily exposed to the sun like face and hands.
Post-inflammatory hyperpigmentation (PIH) can be the outcome of disease processes that affect the skin such as infections (including acne), allergic reactions, mechanical injuries, reactions to medications, phototoxic eruptions, trauma (e.g. burns), and inflammatory diseases. Treatments, including microdermabrasion and laser can also cause PIH in susceptible individuals. Whatever the initiating factor, PIH is more difficult to treat successfully and persists much longer when sun exposure is added to the equation.
Melasma looks like brown to gray-brown patches on the face. While it is mostly restricted to facial areas it also can appear on other parts of the body that get lots of sun, such as the forearms and neck. Multiple factors contribute to the development of melasma “including UV exposure, pregnancy, hormone therapy, genetic influences, certain cosmetics, endocrine or hepatic dysfunction, and selected anti-epileptic drugs. Yet, most of the cases in men and up to one-third of the occurrences in women are idiopathic (Ortonne et al., 2003).” While melasma remains a mystery disorder for many people, it is well-established that of the environmental sources, UV radiation is the most influential (Barankin, Silver, & Carruthers, 2002; Ortonne et al., 2003).
Rosacea is an inflammatory condition whose underlying cause is vascular in nature. When capillaries and veins of rosacea patients become distended due to a stressor (like UV exposure) their weakened state does not allow them to shrink again as happens with normal skin. Over time this results in persistent facial redness and the development of telangiectasia, the visible dilated blood vessels that are a common sign of rosacea. "The significance of sun-damaged skin in rosacea cannot be stressed enough," said Dr. Joseph Bikowski, clinical assistant professor of dermatology at the University of Pittsburgh.
Recent research has suggested that sun exposure may potentially cause blood vessel damage that is associated with the disorder. Several studies now show that ultraviolet light causes an increase in skin of receptors forvascular endothelial growth factor (VEGF). VEGF has a potent effect on blood vessels and may be associated with rosacea by abnormally increasing facial blood supply.
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