Shining bright

Sun spots, skin pigmentation and sun protection: all you need to know to keep your skin blemish-free and healthy

What’s new?
If you thought the abbreviation IRA referred to an Irish military organisation, think again. Nowadays, IRA is something that is very bad for your skin: InfraRed-A rays, which can damage your skin on the cellular level.
So, not only must you constantly watch out for UVA and UVB rays; you now have to protect yourself against IRAs too, since broad-spectrum sunscreen does not shield you from long-term IRA damage.

Where do these rays come from?
Infrared rays hit your skin through a car window, from the heat from your hairdryer, radiation from your computer screen and cellphone, and heat from overhead electric lights in your home or office. IRA rays penetrate deeply, damaging skin cells.
Your only protection against these rays is antioxidants such as vitamins C and E, ferulic acid (derived from bran and oats, and found in SkinCeuticals C&E Ferulic antioxidant serum), idebenone (found in Elizabeth Arden Prevage Triple Defense SPF50 P+++) and phloretin (derived from apples, found in SkinCeuticals).
Antioxidant formulations need to be applied every day, in the correct concentration, to protect skin against cellular damage, says Johannesburg plastic surgeon Dr Mark Steinman, ambassador for SkinCeuticals. And yes, you need to apply a broad-spectrum sunscreen on top of that. By now you certainly should be aware that sunscreens should protect you against UVA (aging) and UVB (burning) rays, and that all sun protection should be broad-spectrum.

Signs of sun damage
The most common signs of sun damage are thinning of the skin, wrinkling and sun freckling. They are mostly caused by sun exposure or sunbed use, and lack of sun protection, says Johannesburg dermatologist Dr Noori Moti-Joosub.
Sun damage is responsible for 80% of all skin aging. Most of the damage is done by the age of 20, adds aesthetic doctor Dr Maureen Allem from Skin Renewal, Parkhurst. “Thereafter, there is a sharp increase in the prevalence of skin changes due to sun aging between the ages of 35 and 49.”
Sun-damaged facial skin includes fine and coarse wrinkle formation, pigmentation changes, freckles, splotchy red skin, sallow colour, dry texture, loss of elasticity, loss of skin tone, sagging dermal tissue, underlying muscle hypertrophy, volume loss in the face and skin cancer. Scientific studies have shown that repeated UV exposure breaks down collagen and impairs the production of new collagen, says Allem.

Preventive measures
Prevention is always the most important step, says Dr Natasha Chapman from the Laserderm Medical Aesthetic Centre, Sandton. Always wear sunblock and a hat when you are in the sun. “Try keeping pimples and acne inflammation under control so that it doesn’t end up as dark marks.”
Smooth on a broad-spectrum sunscreen with at least SPF30 every two hours, since UV rays will make spots darker and undo any progress you’ve made with treatment products.
Even for black or olive-skinned beauties, exposure to the sun is not recommended during the peak hours of 10am to 4pm, cautions Allem. “Like fair-skinned people, they should protect themselves by using an SPF30 sunscreen every day. Wear protective clothing such as caps and sunglasses.”
Awareness of the damaging effects of UV radiation on the complexion, sun avoidance and protection before the age of 20 will reduce your chances of developing sun-damaged and aged-looking skin later in life, she says. Topical antioxidants and broad-spectrum sunscreen protect skin against UVA, UVB and IRA rays.

Your genes and the sun
Pretoria dermatologist Dr Rakesh Newaj says genetics play a role in how you burn. “Your skin colour is something you inherit, and it places you in a certain category (see the accompanying Fitzpatrick Skin Type Scale) that determines susceptibility to sunburn.”
Your genes also determine your susceptibility to moles, skin cancers and pigmentation. Fair-skinned, redheaded individuals are more prone to these problems. “The number of moles present on an individual depends on various factors. Genetics play a role – however, the mode of inheritance is not clearly understood,” says Newaj. “Caucasians have a much higher total number of moles on the face and body, and darker races have a higher incidence of moles on the palms and soles. The number of moles increases from childhood to the third decade of life, then steadily decreases with age.”

Other factors that can increase the number of moles are sun exposure, pregnancy, use of growth hormones, and immuno-suppression (eg HIV).
There are a few genetic diseases (albinism, xeroderma pigmentosum) that increase the probability of developing skin cancer, says Newaj.
Melanoma has a strong genetic link with first-degree family – your chances of getting this form of skin cancer are higher if it exists in your close family. Risk factors for melanoma are very fair skin (skin type I); a family history of melanoma; multiple moles and a type of mole called dysplastic naevus; and previous incidence of melanoma.
If you fall into a genetically prone or risky category, you should take extra precautions to protect your skin from a young age, and in the case of a very fair skin, wear clothes with an SPF. You should also have regular check-ups by a dermatologist, cautions Newaj.

The six Fitzpatrick skin types:

Skin type I: highly sensitive, always burns, never tans.
Skin type II: Very sun-sensitive, burns easily, tans minimally.
Skin type III: Sun-sensitive, sometimes burns, slowly tans to light brown.
Skin type IV: Minimally sun-sensitive, burns minimally, always tans to moderate brown.
Skin type V: Sun-insensitive, rarely burns, tans well.
Skin type VI: Sun-insensitive, never burns, deeply pigmented.


Why everybody needs them
According to Cansa, 20 000 new cases of skin cancer are reported in South Africa every year, and 700 South Africans die of skin cancer annually.
People of all races and all ages need to use sun protection, says Johannesburg dermatologist Dr Pholile Mpofu. “Even though black skin has a natural SPF of 8, a false sense of sun safety can cause severe sun damage and skin cancer.” 

How and when to apply
More is more. Once is not enough! Very few of us apply enough sunscreen often enough.
• Sunscreen should be broad-spectrum, meaning it should protect you from UVA (aging) and UVB (burning) rays.
• Apply sunscreen frequently throughout the day. Re-apply often (every two hours), and always after swimming, exercising and towel-drying.
• Use enough – 2-3 tablespoons of lotion on most of your body, and 2 teaspoons on your face. A 30g tube of sunscreen will just cover the whole body surface.
• Slather sunscreen on at least 30 minutes before you hit the sun.
• Remember to cover the sensitive spots: lips, hands, ears, nose, soles of the feet and bald bits on the head.
• Spray-on sunscreens are easy and quick, and will cover hard-to-reach spots.