What it is
Skin that has had a lot of sun over the years shows deep lines, rough texture, dark spots, visible capillaries and loss of elasticity. It is the result of accumulated ultraviolet radiation, especially on the face, neck, chest and backs of the hands.
The routine has two goals: stop it progressing — strict daily sun protection — and improve what can be improved with retinoids and antioxidants. But with this skin the counter has a third job, which is the most important: recognising lesions that are not cosmetic. Actinic keratoses (rough, reddish patches that are felt more than seen) are precancerous lesions and must be seen by a doctor.
What it needs
Three things:
- Daily broad-spectrum sun protection, reapplied when exposed, plus physical measures (hat, clothing, avoiding midday sun)
- A retinoid at night, introduced gradually, and antioxidants in the morning
- Vigilance: checking the skin and referring any rough lesion that does not go away, bleeds or changes
At the counter
When to recommend it
- Wrinkles, rough texture and dark spots from accumulated sun
- People with heavy lifetime sun exposure
- As prevention so it does not progress
- To teach skin self-examination
When not to
- Rough or scaly patches that do not go away (possible actinic keratoses): refer
- Lesions that bleed, do not heal or grow: refer without delay
- Promising that a cream reverses sun damage
- Retinoids in pregnancy or when trying to conceive
Warnings
- Important Rough patches that do not go away, or lesions that bleed, do not heal or grow: refer to a doctor.
- Important Retinoids increase sun sensitivity: strict sun protection.
- Caution In the EU, retinol in facial cosmetics is limited to 0.3%.
- Caution People with heavy sun damage have a higher risk of skin cancer: regular checks are part of their care.
- Worth knowing A cream does not "repair DNA" or reverse photoageing: it improves appearance, and above all protection stops it progressing.
The routine, step by step
Morning
- Cleanse. Gentle cleanserWithout irritating already damaged skin.
- Antioxidant. Vitamin CComplements protection against sun damage.
- Moisturise. Repairing cream with ceramides or niacinamideImproves the barrier and texture.
- Sunscreen. SPF 50, broad spectrum, reapplied when exposedThe only thing that stops it progressing.
Evening
- Cleanse. Remove sunscreen properlyPrepares the skin for the active.
- Retinoid. Retinol (at most 0.3% in facial cosmetics in the EU) or retinal, starting two or three nights a weekImproves texture and fine lines over time.
- Moisturise. Repairing creamReduces retinoid irritation.
Cosmetic care vs a lesion to refer
| Aspect | Cosmetic care | Refer to a doctor |
|---|---|---|
| Wrinkles and texture | Yes | No |
| Stable dark spots | Yes, once assessed | If they change |
| Persistent rough patches | No | Yes: possible actinic keratoses |
| A lesion that bleeds or does not heal | No | Yes, without delay |
| Prevention | Daily sun protection | Regular checks if there is heavy damage |
With this skin, the counter looks after appearance and, above all, spots what is not cosmetic.
Self-assessment
Three questions. When you check your answers you will see the explanation for each one.
-
Actives improve appearance; only protection stops the damage.
-
They are precancerous lesions: a doctor must see them.
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They help, but they do not repair the damage or replace sunscreen.
Training content. It does not replace the summary of product characteristics or clinical judgement.