- Anna L Chien, MD
Anna L Chien, MD
- Assistant Professor of Dermatology
- Johns Hopkins School of Medicine
- Sewon Kang, MD
Sewon Kang, MD
- Noxell Professor & Chair, Department of Dermatology
- Johns Hopkins School of Medicine
Photoaging is premature skin aging resulting from prolonged and repeated exposure to solar radiation. The changes of photodamage are superimposed on the changes caused by chronological aging and are responsible for most of the age-associated features of skin appearance. (See "Normal aging", section on 'Skin'.)
Salient clinical features of photoaging include fine and coarse wrinkles, dyspigmentation, and loss of elasticity. Photodamage can be partially prevented and reversed with proper sun protection and various prescription medications. Concerns about photoaging are primarily cosmetic. They are influenced by geographical differences, culture, and personal values.
The pathogenesis, clinical features, and medical treatment of photoaging will be discussed here. Procedural techniques for the treatment of photoaging, including injection of soft tissue fillers or botulinum toxin, and laser therapy are discussed separately. (See "Injectable soft tissue fillers: Overview of clinical use" and "Overview of botulinum toxin for cosmetic indications" and "Botulinum toxin for cosmetic indications: Treatment of specific sites" and "Ablative laser resurfacing for skin rejuvenation" and "Nonablative skin resurfacing for skin rejuvenation".)
Photoaging is responsible for the majority of age-associated cosmetic skin problems in fair skinned populations. In European and North American adult populations with skin prototypes I, II, and III (table 1), the prevalence of photoaging may be as high as 80 to 90 percent .
Risk factors for photoaging include age, sex, skin prototype, and geographic location. Individuals with fair and less pigmented skin are at increased risk for photodamage and sun-induced skin cancer. The amount of time spent in the sunlight over a lifetime is a key risk factor for photoaging. (See "Epidemiology, pathogenesis, and clinical features of basal cell carcinoma", section on 'Risk factors' and "Epidemiology and risk factors for cutaneous squamous cell carcinoma", section on 'Risk factors' and "Risk factors for the development of melanoma", section on 'Geographic and ethnic variation'.)
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- CLINICAL FEATURES
- OVERVIEW OF MANAGEMENT
- TOPICAL RETINOIDS
- Pretreatment counseling
- - Indications
- - Instructions for application
- CHEMICAL PEELS
- OTHER THERAPEUTIC OPTIONS
- SUMMARY AND RECOMMENDATIONS