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Photoaging

Authors
Anna L Chien, MD
Sewon Kang, MD
Section Editor
Craig A Elmets, MD
Deputy Editor
Rosamaria Corona, MD, DSc

INTRODUCTION

Photoaging, also called extrinsic aging, is premature skin aging resulting from prolonged and repeated exposure to solar radiation [1]. The changes of photodamage are superimposed on the changes caused by chronologic aging (the so-called intrinsic or programmed aging) and are responsible for most of the age-associated features of skin appearance. Salient clinical features of photoaging include fine and coarse wrinkles, dyspigmentation, and loss of elasticity. (See "Normal aging", section on 'Skin'.)

Photodamage can be partially prevented and reversed with proper sun protection and various prescription medications. However, concerns about photoaging are primarily cosmetic and 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 laser therapy, injection of soft tissue fillers, and botulinum toxin, are discussed separately. (See "Nonablative skin resurfacing for skin rejuvenation" and "Ablative laser resurfacing for skin rejuvenation" and "Injectable soft tissue fillers: Overview of clinical use" and "Overview of botulinum toxin for cosmetic indications".)

EPIDEMIOLOGY

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 phototypes I, II, and III (table 1), the prevalence of clinically detectable photoaging may be as high as 80 to 90 percent [2].  

Risk factors for photoaging include older age, male sex, skin phototypes I to III, high occupational or recreational sun exposure, and living in geographic locations with high sun irradiation [3]. 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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Literature review current through: Sep 2017. | This topic last updated: Aug 22, 2017.
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