Dramatic Photo Reveals Sun's Effect on Skin

Courtesy Jennifer R.S. Gordon, M.D., and Joaquin C. Brieva, M.D., New England Journal of Medicine, 2012

Dramatic photo shows the suns damaging effect on skin.

Truck driver William (Bill) Edward McElligott is two different ages, 69 and 86 years old.

The right side of the veteran trucker driver's face looks his actual age of 69. But the left side that got much more sun while he was on the road for 28 years looks like that of an 86-year-old, with wrinkles and sagging skin.

McElligott says, "It was a semi-route, I'd have six to eight stops: 6 a.m. to 3 p.m. on the road. My left arm was always more tan than my right…" Ultraviolet A (UVA) rays transmitted through window glass, penetrated his the epidermis and upper layers of his dermis, damaging the tissue.

McElligott suffers from unilateral dermatoheliosis, or photo-aging. The condition is caused by chronic exposure to the sun's UVA and UVB rays. In his case, it only affected the left side of his face because of his work. As he drove, he received much many hours of sunlight through the left window of his vehicle.

It took 15 years before McElligott noticed a difference in the sides of his face. He finally decided to quit ignoring the condition when his grandchildren kept on him about it.

"Only reason I went in, the kids were asking me what these bumps are and it's hard to explain to little kids, so I went to see if I could have those bumps removed," he told ABC News.

Dermatologists at Northwestern University in Chicago Jennifer R.S. Gordon and Joaquin C. Brieva examined McEligott. "It was very stark," said Dr. Gordon. "We are used to seeing photo damage, photo aging every day, (but) for it to be so one sided? We were taken aback."

Their study was published in the New England Journal of Medicine with a high resolution photo:

A 69-year-old man presented with a 25-year history of gradual, asymptomatic thickening and wrinkling of the skin on the left side of his face. The physical examination showed hyperkeratosis with accentuated ridging, multiple open comedones, and areas of nodular elastosis. Histopathological analysis showed an accumulation of elastolytic material in the dermis and the formation of milia within the vellus hair follicles. Findings were consistent with the Favre–Racouchot syndrome of photodamaged skin, known as dermatoheliosis.

The patient reported that he had driven a delivery truck for 28 years. Ultraviolet A (UVA) rays transmit through window glass, penetrating the epidermis and upper layers of dermis. Chronic UVA exposure can result in thickening of the epidermis and stratum corneum, as well as destruction of elastic fibers. This photoaging effect of UVA is contrasted with photocarcinogenesis.

The doctors recommended sun protection and topical retinoids, as well as periodic monitoring for skin cancer.

As the weather begins to warm up, this is a powerful reminder of the negative effects of sun exposure. If you are going to be exposed to the sun in any way, even if you are not at the beach or a swimming pool, use protection!

Sources:
http://www.nejm.org/doi/full/10.1056/NEJMicm1104059#t=article
http://news.yahoo.com/blogs/abc-news-blogs/sunny-side-old-pic-reveals-suns-aging-effects-155054732--abc-news-health.html
http://gizmodo.com/5914862/shocking-proof-of-how-the-sun-makes-you-age-prematurely