Aging Skin: Blemishes and Nonmelanoma Skin Cancers

Description

Alternative Names

Risk Factors

Exposure to Sun in Childhood. It is estimated that 50% to 80% of skin damage occurs in childhood and adolescence from intermittent, intense sun exposure that causes severe sunburns. In spite of this now well-known effect, many people still believe that a tan in children signifies health. And, even many parents who are concerned about sun exposure still rely too much on sunscreen and not enough on protective clothing.

The Elderly. Nearly half of people between the ages of 65 and 75 years old have at least one significant skin problem. And the majority of people over 75 have at least one skin disorder and many have three or four. Everyone experiences skin changes as they age, but a long life is not the sole determinant of aging skin. Family history, genetics, and behavioral choices all have a profound impact on the onset of aging-skin symptoms.

Activities Leading to Overexposure to Sunlight or Ultraviolet Radiation

Of all the risk factors for aging skin, exposure to UV radiation from sunlight is by far the most serious. Indeed, the vast majority of undesirable consequences of aging skin, including basal cell and squamous cell carcinomas, occur in individuals who are repetitively exposed to the sun. (Melanoma is more likely to be caused by intense exposure to sunlight in early life.) People at risk include the following:

• People who are outdoors for long periods of time either for work or leisure.
• People who regularly attend tanning salons or use tanning beds. A 2002 study indicated that regular use significantly increases the risk for nonmelanoma skin cancers. Fair women under age 50 were at particular risk.
• People who are treated with PUVA for psoriasis or other skin problems. This procedure uses ultraviolet radiation. Unfortunately, researchers are finding that the increased cancer risks of PUVA may manifest 15 or more years after therapy. Psoriasis, in fact, may increase the risk for squamous cell carcinoma regardless of treatment.

Skin Types and Ethnic Groups

People with light skin, blue, gray, or green eyes, red or blond hair, and lots of freckles are at highest risk than people with other skin types for developing skin cancers, including melanoma. The risk increases for those who are easily sunburned and rarely tan, particularly if they live close to the equator where sunlight is most intense. One study noted that Caucasians, particularly men, who have fewer dark pigment (melanin) cells as measured in the upper inner arm were more likely to develop melanoma and other skin cancers. Darker ethnic groups or those with swarthy complexions are not immune, however.

Experts have devised a classification system for skin phototypes (SPTs) based on the sensitivity to sunlight. It ranges from SPT I (lightest skin plus other factors) to IV (darkest skin). People with skin types I and II are at highest risk for photoaging skin diseases, including cancer. It should be noted, however, that premature aging from sunlight can affect people of all skin shades.

Tanning and Sunburn History

Smokers

Cigarette smokers are more prone to skin cancers, including squamous cell carcinoma and giant basal cell carcinomas. And heavy smokers are almost five times as likely to have wrinkled facial skin than nonsmokers.

Radiation Therapy

Individuals who have received radiation therapy (such as radiation treatments for leukemia, goiters, ankylosing spondylitis) are at higher risk of developing basal cell carcinomas and squamous cell carcinomas.