A Primer on Sunburn

The basic structure of skin is a protein based substance called Collagen.  A medical term for skin is Dermis and, technically speaking, collagen resides within dermis.  As simply stated as possible, the result is sun damaged skin.  When collagen is destroyed, the dermis burns and, ultimately, because burning contracts, wrinkles form.

Medically speaking, small transporters called capillaries feed the skin with the oxygen and nutrients needed to grow, shed, re-grow, be elastic, and appear healthy.  When the collagen, which is an integral part of the skin, capillaries, and blood, is burned, the network of capillaries are damaged or devastated; thus, what actually happens is the blood supply to the skin is cut off and, ultimately, there is permanently sun damaged skin.  The degree to which the skin is burned, and the number of times, determines how visible the damage is.  Another major factor is called phototypes, which means the existing pigmentation of an individual’s skin; thus, lighter skinned individuals are affected more frequently and can be more severely.  In fact, skin types (skin phototypes) are classically divided into a total of six categories based on the tendency to burn.  The six skin phototypes are shown below.  Additionally, the minimum SPF recommendation for sun protection is shown in the far right column:

Skin
Phototype

Description

Typical
Features

Minimum
SPF

I

Always burns, never tans

White skin, blue/ hazel eyes, blond/ red hair

?15

II

Always burns, tans minimally

Fair skin, blue eyes

?15

III

Burns minimally, tans slowly

Darker Caucasian skin

10 – 15

IV

Burns minimally, tans well

Light brown skin, Mediterranean

6-10

V

Rarely burns, tans profusely/darkly

Brown skin, Middle Eastern, Latin American

4-6

VI

Never burns, always tans, deeply pigmented

Dark brown or black skin

None

Most long term sun damaged skin occurs during youth, making it critically important to protect the skin from burning in early years.  The damage can last a lifetime and cause more serious skin issues later in life.

All natural skin care products starting with sun protection both for the face and body are the place to start.

The appearance of sun damaged skin is generally easily recognized and can be separated from the changes that occur normally through the aging process, which is usually characterized as smooth, fine, pale, and wrinkling.  Typically, coarse wrinkles and a weathered, leathery texture are associated with sun damaged skin.  Often patchy, irregular blends of pigmentation reflect serious skin damage and may feel dry and/or scaly.  Medically speaking, what’s happening is chronic sun exposure actually produces a thickened layer in what’s known as the upper dermis, which is called solar elastosis.  This elastosis sometimes gives a yellowish skin look and is typically made up of broken blood vessels.  If the damage is severe, thin skin and sometimes bruising may be seen on the hands and forearms.

The ultimate reason, other than appearance degredation as we age, is dermis burn may lead to skin changes that have the possibility of ending up as skin cancers.  Chronic sun exposure, and most often involving fair-skinned individuals, may lead to pre-cancerous small reddish or reddish-brown rough areas with a hard surface on the skin.  If they progress, they develop a thick, rough whitish scale; typically seen on the ears, scalp, face, and back of the hands.  Sometimes the lower legs are also at risk.  The most common type of skin cancer progression from sunburn is Basal Cell Carcinoma (BCC’s).  BCC’s are by far the most significantly common type of skin cancer.  They can look like well-defined, slightly scaly patches resembling psoriasis.  They may remain without changes for a long time if not treated and grow.  Fibreotic BCC’s are slightly pigmented and appear as a lesion on the face.

Squamanous Cell Carcinoma (SCC) is the second most common type of skin cancer.  SCC typically comes from severely sun damaged skin.  They are usually red and scaly lesions and have a depth or thickness to them.  It is extremely rare for SCC to develop from any other reason than severe sunburn.

Malignant Melanoma is the most dangerous of all skin cancers.  They appear mostly as intensely pigmented lesions.  Any suspicious skin lesion should always be referred to a qualified medical resource.  Early detection of Melanoma is vital because they can be extremely fast-growing.

From the suns’ light, it is actually the ultraviolet rays that burn the Collagen that is present in the dermis.  The medical term is called Oxidative Damage, which is a photo-chemical reaction that produces oxidation of basic DNA molecules, a key body acid called Nucleide Protein and Lipids.  As the ultraviolet rays burn through the dermis into the collagen, the oxidative damage shows itself as a change to pigmentation (typically reddened or burned) that goes through phases of scaling, dryness, and ultimately permanent wrinkles.  This is where sunscreen is key.  The sunscreens are developed to actually protect against the ultraviolet rays.  They actually block the ultraviolet rays at various levels, depending on the SPF rating of the lotion.  There are actually two levels of ultraviolet light (UVL), both A and B.  UVB is easily screened by low SPF sunscreens.  UVA is the most difficult to protect the dermis against.  Much has been written about how to actually apply the lotion, the actual formula is SPF is calculated with a quantity of 2 mg. of sunscreen per centimeter squared.  Anything below the formula, the protection is minimal, and anything above is wasteful but protective.

Research indicates Vitamin C, E, and Zinc are also supportive in protecting the body both before and after exposure to the sun.  Work is underway with natural skin care products to combat the effects of sunburn and aging; these include potent plant antioxidants.  The major products are as follows: Silymarin, which is milk thistle extract; Soy Isoflavones (specifically Genistein and Gaidzen), which have collagen synthesis effect; and Tea Polypheols (typically known as Green Tea).

There is clear evidence that the use of sunscreens used 100% of the time the sun is encountered, have a beneficial effect in preventing Squamous Cell Carcinoma.  It is not so clear, however, that sunscreens have the same effect in preventing Basal Cell Carcinoma or Malignant Melanoma.  What seems to be most important in the ultimate development of these cancers, is the age at which unprotected sun exposure occurs and the type of sunlight experienced, i.e. near the Equator, in the mountains, or proximity to UV reflection from water.

In summary, use sunscreens to prevent the discomfort of sunburn, prevent sun damaged skin, and possible protection from Squamous Cell and other cancers.  It is critically important to protect the body from the sun, starting with the earliest days possible using a high enough SPF level and in sufficient quantity.

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