Q: I’ve been out in the sun most my life. My forehead has been sunburned a thousand times. I now wear a hat. Is there something I could use to repair the damage to the areas of my forehead that have been sunburned so much?
A: The first thing I tell patients is that going forward, they really need to get into the habit of applying sunscreen, especially on vulnerable places like the forehead. That’s not new or exciting but it’s one of the most valuable pieces of advice I can give. Wearing a hat is also a good idea.
Sun-damaged skin can be treated with topical retinoids-creams or gels that contain chemicals derived from vitamin A. Although they were originally approved for treatment of acne and later, psoriasis, topical retinoids have proved to be effective for repairing sun-damaged skin. They lighten sun-induced freckling (lentigines) and other types of facial pigmentation and improve the overall appearance of the skin.
Behind these cosmetic changes are some real structural differences in the skin tissue. The topical retinoids decrease the number of atypical skin cells produced by sun exposure and normalize the growth of keratinocytes. They also induce the production of collagen, so some of the small wrinkles in the skin may disappear.
Tretinoin, sold as Retin- A, was the first topical retinoid. Now you can buy it as a generic, and it’s the active ingredient in other products (Avita, Renova). Other prescription topical retinoids include adapalene (Differin) and tazarotene (Avage, Tazorac).
Topical retinoids aren’t a quick fix. You’ll get the best results if you use them for several months-even longer. They’re also expensive, although you apply just a little at a time, so a tube should last.
The UVB part of the light spectrum penetrates the skin more easily after it has been treated with topical retinoids. So if you go this route, you need to be vigilant about applying sunscreen and limiting your sun exposure.
Dr. Kenneth Arndt, Harvard Health Letter Editorial Board
