Most of what people call aging skin is sun damage. The estimates vary but the direction does not: the large majority of visible facial aging comes from ultraviolet exposure rather than from the passage of time. That is why two people the same age can look a decade apart, and it is also the reason sun damage is more treatable than aging, because damage can be removed in a way that time cannot.
Sam Assassa, MD has been featured on NBC and Univision for his work in non-surgical aesthetics. He founded Beverly Hills Aesthetics in 1995, is board certified in Internal Medicine, and has performed more than 25,000 aesthetic procedures.
What Sun Damage Actually Does
Ultraviolet light causes several different changes and they surface at different times, which is why sun damage does not look like one thing.
Pigment. UV stimulates the cells that produce melanin, and over years that production becomes uneven and localised, forming the flat brown patches called age spots or sun spots.
Collagen and elastin breakdown. UV degrades the structural proteins in the dermis directly. The skin loses firmness and the ability to recoil, and it creases more readily and recovers less well.
Texture change. The surface becomes rougher, pores appear larger as their supporting collagen fails, and fine lines etch where the skin can no longer bounce back.
Vascular change. Persistent redness and visible small vessels, particularly across the cheeks and nose.
Why It Appears Later Than the Exposure
This is the part that surprises people. The damage accumulates silently for decades before it becomes visible, which means what you are seeing now is largely the result of exposure in your teens and twenties.
It also means two things worth knowing. Protecting your skin now still matters, because the exposure you accumulate today surfaces later. And treating existing damage does not protect you from future damage, so results are held by patients who use sun protection afterward and eroded by patients who do not.
Sun Damage Versus Sagging
These are related and they are not the same problem, and treatment differs.
Sun damage is a quality problem in the skin itself: pigment, texture, tone, and fine lines. It responds to treatments that remove or remodel the damaged tissue.
Sagging is a structural problem underneath: lost volume, descended tissue, and loss of elasticity. It responds to restoring volume, repositioning, or firming, and it is covered on the sagging skin page.
Sun exposure contributes to both, since collagen breakdown affects firmness as well as texture. But the treatments are different, and a patient treated for one when they needed the other ends up disappointed.
How Sun Damage Is Treated
- Fractional CO2 laser resurfacing removes damaged tissue and prompts the skin to rebuild. The most improvement per session, with recovery to plan around.
- Chemical peels lift the pigmented and damaged surface layers, with depth matched to your skin.
- Microneedling stimulates collagen without removing tissue, over a series, with a lower pigmentary risk.
- Skin boosters improve hydration and quality in thin, damaged skin.
Skin type genuinely changes the recommendation. Ablative treatment carries a higher risk of post-inflammatory hyperpigmentation in deeper skin tones, meaning treatment can leave darkening worse than what you started with, and that is assessed before anything is scheduled.
Have Your Skin Assessed in Beverly Hills
Dr. Assassa will assess how much of your concern is pigment, how much is texture, and how much is structural, since those need different treatment. Request a consultation or schedule your appointment online.