Please Wear Sunblock

Get in the habit of always wearing sunblock when you leave the house.  Find a moisturizer that contains some amount of sunblock for daily use and if you know you are going to be in a lot of sunshine, have one with a higher SPF that you can add.  Keep some in your car.  I love the spray sunblock, personally.  If you like how you look with sun-kissed skin, let it happen gradually and help it along with a little self-tanner that builds color over time (especially if you are putting it on your face).

This man is 69 years old.

He drove a truck for 28 years.

The premature aging from sun damage to the left side of his face is extensive enough to warrant a feature in the New England Journal of Medicine.

Trucker or not, don’t forget your sunscreen.

A 69-year-old man presented with a 25-year history of gradual, asymptomatic thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis. Histopathological analysis showed an accumulation of elastolytic material in the dermis and the formation of milia within the vellus hair follicles. Findings were consistent with the Favre–Racouchot syndrome of photodamaged skin, known as dermatoheliosis. The patient reported that he had driven a delivery truck for 28 years. Ultraviolet A (UVA) rays transmit through window glass, penetrating the epidermis and upper layers of dermis. Chronic UVA exposure can result in thickening of the epidermis and stratum corneum, as well as destruction of elastic fibers. This photoaging effect of UVA is contrasted with photocarcinogenesis. Although exposure to ultraviolet B (UVB) rays is linked to a higher rate of photocarcinogenesis, UVA has also been shown to induce substantial DNA mutations and direct toxicity, leading to the formation of skin cancer. The use of sun protection and topical retinoids and periodic monitoring for skin cancer were recommended for the patient.

Jennifer R.S. Gordon, M.D.
Joaquin C. Brieva, M.D.
Northwestern University, Chicago, IL

via Unilateral Dermatoheliosis — NEJM.

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