Sun damage: what is happening under your skin and what can be undone

Sun damage bills you late. You spend a summer on the lake, a few seasons of Saturday errands, years of driving with your arm near the window, and none of it shows up for a decade or two. Then it arrives all at once as a spot that was not there before, or skin that looks older than you feel.

What UV actually does

Two kinds of ultraviolet light reach the ground. UVB causes sunburn, peaks midday, and is mostly stopped by glass. UVA goes deeper, passes straight through car and office windows, and stays roughly constant all day and all year. UVA drives most premature aging and contributes heavily to skin cancer.

UV damages the DNA inside skin cells. Your body repairs most of it. Not all. Errors accumulate, melanocytes start producing pigment unevenly, and the collagen and elastin holding your skin taut break down faster than they rebuild. The visible result is spots, slackness, and lines.

The invisible result matters more. UV-driven mutations cause the three common skin cancers: basal cell carcinoma, squamous cell carcinoma, and melanoma. Sun damage is a medical issue that happens to also be a cosmetic one.

What it looks like

Flat brown patches on the face, hands, chest, and shoulders usually come first. They get called age spots, but they track sun exposure rather than birthdays.

Actinic keratoses are the ones that matter clinically. Rough, scaly patches that feel like sandpaper and often are easier to feel than see. They are precancerous, and a percentage progress to squamous cell carcinoma without treatment. If a patch has stayed rough for weeks despite moisturizer, have it looked at.

Beyond that: broken capillaries, thickened leathery texture, slackness where skin used to spring back, and a general dullness.

Sunscreen, every day, forever

Daily broad-spectrum sunscreen is the single most effective thing available for preventing damage, slowing aging, and lowering cancer risk. Not before the beach. Every morning.

The reason is UVA. It comes through clouds and glass and it is there in January. Your skin accumulates exposure on overcast Tuesdays just as it does in July.

SPF 30 minimum, SPF 50 if you are fair, have existing damage, or carry elevated risk. Broad-spectrum means it covers UVA as well as UVB. Beyond that, use one you will actually wear, because the best formula is the one that does not sit unopened in a drawer.

This matters everywhere, and it matters across every skin tone. Skin cancer in darker skin is diagnosed later and does worse, partly because the risk gets dismissed.

What can be reversed

A meaningful amount, with the right approach.

For pigmentation and broken capillaries, intense pulsed light photofacials break down excess melanin so the body can clear it, evening out tone across a series of sessions. Cleaver Dermatology & Aesthetics offers IPL at locations throughout North Georgia.

Laser resurfacing, including fractional and CO2RE options, goes deeper. It addresses pigment and the texture changes from collagen loss at once, and triggers a remodeling response that keeps improving for months afterward.

Actinic keratoses need treating rather than watching. Options include cryotherapy, prescription topicals, photodynamic therapy, or excision depending on how many there are and where. Treating them is how you interrupt the path to squamous cell carcinoma.

Chemical peels and prescription retinoids handle surface damage and speed the turnover of damaged cells.

The cancer question

Not all sun damage becomes cancer. All skin cancer comes from sun damage. That relationship is the argument for annual screening once you have accumulated real exposure, which describes most adults in Georgia.

During a full-body exam your provider checks every sun-exposed area for changes you would not spot yourself. If something needs a biopsy it happens at the visit, and if it is skin cancer, Dr. Nathan Cleaver's fellowship training in Mohs surgery means treatment is available locally.

Cleaver Dermatology & Aesthetics serves Cumming, Gainesville, Roswell, Johns Creek, Dahlonega, Canton, Toccoa, Lavonia, and Dawsonville. Appointments can be booked online.