Courtesy of INSIDE magazine


Despite the negativity surrounding sun exposure, we do need it to survive. Sunlight helps skin synthesise vitamin D, which is critical for the absorption of calcium and phosphorous as well as for regulating calcium metabolism in the bone. But excessive sunning leads to photodamage, making skin sallow and mottled with brown and white spots, and causing wrinkles. Prolonged photodamage may also induce pre-cancerous skin growths and skin cancer.

Those who doggedly seek a ‘healthy’ tan should be aware that no tan is ever healthy, and tanning is never safe – whether outdoors or in a studio. When there’s a tan, there’s photodamage. Our skin is resilient in that it can heal and recover from mild damage. But chronic sun exposure overwhelms this ability, causing skin problems like those highlighted.

Predominantly caused by ageing and photodamage, areas frequently exposed, such as the face and arms, are more susceptible to wrinkles than areas covered, like the abdomen. Proper moisturising and avoidance of harsh skincare products will prevent the skin surface from drying out and sagging, while skin wounds or inflammation treated early will limit scarring.

Lines are best prevented with judicious use of sunscreen, protective clothing and shades, especially during the 10am-4pm period.

Caused by melanin in the skin, normal pigment levels are determined by ethnicity. Dark spots or patches, however, can indicate photodamage, such as solar lentigines from over-sunning, or the darkening of freckles in people who are predisposed. While medical treatments can eliminate the spots, they will recur if the skin is again overly sun exposed.

The latest five-yearly report from the Singapore Cancer Registry identifies skin cancer as the sixth most common cancer in adults, often presenting as basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma.

Both BCC and SCC appear as persistent growths that are neither itchy nor painful, much like a small, flaky and localised rash. But unlike rashes, skin cancers do not go away untreated and will increase in size. In severe cases, the patches become so fragile that they break and bleed even if gently brushed against.

Melanoma, on the other hand, tends to appear as a growing, oddly coloured and irregularly shaped mole. Detected early, it can be surgically removed with a high chance of curing the patient. But if allowed to advance and spread into the skin, it becomes fatal, and is responsible for 75 per cent of deaths from skin cancer in the US.

Anyone who frequently works under or is exposed to the sun’s heat, or who is often in contact with radioactive materials, should go for regular check-ups with a dermatologist.

The common treatments for photodamage include:

  • Tretinoin cream – prescribed to reduce wrinkling, discolouration and other signs of photodamage
  • Chemical or acid peel – where even a light peel performed repeatedly can improve the appearance of fine lines, although deeper wrinkles require more aggressive peels.
  • Intense pulsed light therapy
  • Laser therapy, such as the non-invasive CoolTouch Laser, stimulates collagen formation and lightens wrinkles. Slightly more aggressive therapies like Fractional CO2 laser resurfacing can show results in a single session.
  • Radiofrequency skin tightening with the Exilis system
  • Injection of botulinum toxin to abolish or soften creases by relaxing facial muscles

That said, the best treatment is still a healthy, smoke-free lifestyle with proper skincare and avoidance of excessive sunning.

Dermatologist in Singapore, Dr Cheong Lai Leng, LL Cheong Skin & Laser Clinic, cautions that some skin treatment procedures involve downtime, so it is important to know the posttreatment period and plan time away from normal activities.

She also advises patients to inform their dermatologists of any changes in their health or in the condition of their skin before commencing on a procedure, as skin treatment is not for everyone. Those with skin diseases like lupus or those taking medications like Roaccutane are sensitive to strong light, and should not be subjected to IPL or laser therapy. Pregnant women and those with muscle weakness diseases should avoid Botox injections, while patients with implanted cardiac pacemakers must avoid radiofrequency treatments.

Dr Cheong Lai Leng
Consultant Dermatologist

MBBS (Singapore), M.Med (Internal Medicine),
MRCP (UK), FAMS (Dermatology).
Corr. Fellow, American Society for Dermatologic Surgery

3 Mount Elizabeth
#09-09 Mount Elizabeth Medical Centre
Singapore 228510
Tel : (65) 6836 1480
Fax : (65) 6836 1481
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