We know you know by now: Sun exposure can damage your skin and potentially cause cancer, so you should do your best to protect yourself. Specifically, you’re supposed to wear a broad-spectrum SPF 30+ sunscreen daily (yes, even if you’re hanging out inside), you need to reapply it every two hours or so if you’re spending time outdoors, and you should seek shade or wear a broad-brimmed hat when the sun’s rays are at their strongest (between 10 a.m. and 4 p.m.).
We also know that, chances are, you haven’t always followed those golden rules to a T. First of all, they’re tedious and often inconvenient. (Have you ever been excited to slather yourself in sunscreen when you’re rushing out the door?) Plus, you may not have known (or cared) about them back in the day. Maybe you didn’t even realize baking in a tanning bed twice a week (as one did in the early 2000s) was terrible for your skin until it was too late. Or perhaps, in your hormonal teenage mind, your goal of a golden glow outweighed the risks, so you swapped SPF for baby oil at the pool every summer.
Regardless of your specific circumstances: If you worshiped the sun a little too wholeheartedly in your younger years and you’re dealing with tanner’s remorse, you’re probably wondering if there’s anything you can do to reverse sun damage that can lead to skin cancer. We were too, honestly, so we asked a couple of dermatologists to find out.
How, exactly, do the sun’s rays harm your skin cells and potentially lead to cancer?
Before we get into reversing sun damage, it’s important to understand how it happens.
Basically, sun exposure bombards your skin cells with ultraviolet (UV) radiation. In response, your body produces melanin (the pigment that gives skin—and hair—its particular color) as a shield against the DNA-damaging effects of those UV rays. However, when melanin fails to provide sufficient protection (prime example: when you’re on the beach all day and end up with a lobstery sunburn), the sun’s radiation can successfully damage DNA, leading to mutations that alter cellular behavior and might eventually cause skin cancer.
“Mutations in the DNA are like a mismatch, and when you start creating mismatches, what ultimately happens is, skin cells that are normally programmed to divide and behave in a certain way now don’t have anything keeping them in check,” Rachel Nazarian, MD, FAAD, a board-certified dermatologist at Schweiger Dermatology Group in New York City, tells SELF. For the record, even if you don’t always end up with angry, blistery skin after not sufficiently protecting your skin from UV rays, that doesn’t mean that you got off scot-free. (Sorry, we wish!) “There’s no such thing as a safe tan, because only after radiation penetrates the nucleus and tries to get inside that DNA does your body release melanin,” Dr. Nazarian says. In other words, any level of tanning is a sign of sun damage.
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While UV radiation can indeed cause mutations in DNA, not everyone who’s spent a lot of unprotected time outside develops skin cancer—nor does everyone accrue the same level of damage from the sun’s rays (or a tanning bed’s UV bulbs), Dr. Nazarian explains. Your body has mechanisms in place that help to repair that DNA damage—but prolonged and/or excessive sun exposure ups the chances that your cells won’t recover, potentially leading to various types of skin cancers, including melanoma, the most serious kind.
Genetics and individual factors like melanin levels also play a role in whether that exposure leads to cancer. While it’s definitely true that having fairer skin (and, therefore, less protective melanin) puts you at a higher risk for melanoma, people of all skin types can and do develop skin cancers. In fact, you’re more likely to get diagnosed with late-stage melanoma if you’re Hispanic or Black; 52% of Black people and 26% of non-white Hispanic people don’t catch their melanoma until it’s already at an advanced stage, whereas just 16% of non-Hispanic white patients get diagnosed this late, according to the Skin Cancer Foundation. Even more sobering: The five-year melanoma survival rate is just 71% for Black people, compared with 94% for white people.
So, the big question: Is it possible to undo DNA damage from years of unprotected sun exposure, or are you pretty much screwed?
Just because you haven’t been diagnosed with skin cancer doesn’t mean a history of sun damage is no big deal or that you can’t take action to protect yourself now. “Dermatology is not just a watch-and-wait specialty anymore—there are things you can do to decrease your [skin cancer] risk,” Dr. Nazarian says.
You won’t ever be able to fully erase the past, but there are a few treatments that can undo at least some previous DNA damage, like lasers and special topical creams. In other words, if you’ve accrued a lot of sun damage over the years, no, you’re not necessarily screwed. Here are some options that might help.
Dark moles aren’t the only signal that you have potentially serious sun damage. If you have red, brown, gray, white, or flesh-toned patches of rough skin known as actinic keratosis (AK)—a type of precancerous growth that shows up on commonly sun-exposed areas, like your face, hands, ears, and neck—your doctor may prescribe you an Rx-only topical medication, such as imiquimod or fluorouracil cream. These treatments work by targeting unhealthy cells and killing them without harming the surrounding healthy skin.
“You can think of them as chemotherapy creams,” Dr. Zeichner says. “They attack rapidly dividing cells…. But in order to clear the damaged skin, they cause scabbing.” If you have actinic keratosis (or certain types of squamous cell and basal cell carcinoma, which often show up as little sores, pimples, or bumps that change over time and won’t heal), your primary care doctor or dermatologist can prescribe these treatments, which may be covered by insurance. Just know that there’s a major downside: The process of scabbing and healing can take up to a month. It’s brutal, we know, but when you consider that the alternatives (like surgical removal and cryotherapy) are more likely to leave visible scars, it might be a little easier to swallow.
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(Also important to note: Don’t try to self-diagnose actinic keratosis—if you have the AK symptoms above, you should see a dermatologist to rule out other conditions like psoriasis, eczema, or some other skin reaction.)
Fractional laser treatments, which require a week or so of downtime, per Dr. Zeichner, are another option for getting rid of damaged cells and reducing the risk of nonmelanoma skin cancers. Unlike the prescription creams we just mentioned, though, they’re not typically covered by insurance and can be quite pricey—between $1,200 and $2,000 to treat your whole face, depending on where you live and where you go—and you may need more than one session to get your desired results.
“There is a good body of data showing that fractional lasers, like Fraxel, remodel the skin and lower the risk of developing skin cancers,” Dr. Zeichner says. In fact, dermatologists actually use these devices to treat AK. “The laser works by punching microscopic holes in the skin, creating a controlled wound, and then taking advantage of the skin’s ability to heal itself back up in a more healthy manner,” Dr. Zeichner explains. “It can smooth wrinkles, it can lighten dark spots, and it may actually undo some DNA-level sun damage.”
There are risks to consider, though—including the potential for increased hyperpigmentation or hypopigmentation (light spots)—so you definitely want to talk to a dermatologist to find out if fractional laser treatments are the right choice for you and your skin.
Photodynamic therapy (PDT) is used primarily as a treatment for multiple AKs and early basal cell and squamous cell carcinomas (nonmelanoma skin cancers). It’s an in-office procedure where a dermatologist applies a photosensitizing (light-absorbing) fluid called aminolevulinic acid to your skin. Once it’s absorbed (which typically takes anywhere from 30 to 90 minutes to overnight), your doctor will then activate it by exposing your skin to a light source (either a laser or blue light device) for 15 minutes or so, Dr. Zeichner explains.
Though this treatment can reverse sun damage by specifically targeting compromised cells, it’s not always covered by insurance, it’s painful, and it can be time-consuming (you also can’t go outside in the sun for 48 hours afterward). So, Dr. Zeichner says, your doctor is unlikely to recommend PDT unless you’ve been diagnosed with basal cell carcinoma and you’re not a great candidate for surgical removal (known as Mohs surgery)—either because you have several cancers in one area (making healing from excision too traumatic) or the cancer is in a spot that could drastically affect your appearance (like your nose).
The takeaway: If you know you haven’t been the best about UV damage control in the past, talk to a primary care provider or, ideally, meet with a dermatologist to find out which treatments and preventative strategies are best for you. If we’ve learned anything from reporting this article, it’s that the earlier you kickstart your recovery, the less painful (and pricey) your options could be! Oh, and wear sunscreen! You may not be able to totally reverse previous DNA damage, but protecting yourself from the sun now is the best thing you can do to reduce your skin cancer risk.
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