What Sun Damage Actually Looks Like and When to See a Dermatologist

Most people know that too much sun is bad for the skin. But what does sun damage actually look like, how do you know when a change on your skin deserves medical attention, and who should you call when it does? Whether you spent years in a tanning bed, logged decades of beach days without SPF or simply never thought much about sun protection until recently, here is what you need to know about recognizing sun damage and taking the right next steps.

What exactly is sun damage?

Sun damage, also called photoaging or solar damage, refers to the cumulative harm ultraviolet radiation does to the skin over time. There are two types of UV rays that reach the skin: UVA rays, which penetrate deeply and are present year-round even through clouds and windows, and UVB rays, which are strongest in summer and are the primary cause of sunburn. Both types contribute to skin damage, premature aging and skin cancer risk.

Importantly, sun damage is cumulative. A single sunburn heals, but the underlying cellular damage adds up over a lifetime, which is why skin cancer rates continue to rise even as overall sun awareness has improved.

What are the visible signs of sun damage?

Sun damage can appear in several ways, and not all of them look the same.

Freckles and sunspots, also called solar lentigines or liver spots, are flat brown or tan spots that develop on sun-exposed areas, including the face, hands, shoulders and chest. They are among the most common and earliest visible signs of cumulative UV exposure.

Uneven skin tone and hyperpigmentation occur when UV radiation triggers excess melanin production, leading to patches of darker skin that can be difficult to fade without treatment.

Rough or leathery texture develops when the skin loses elasticity and collagen due to long-term UV exposure. This is a hallmark of significant photoaging.

Fine lines and wrinkles that appear earlier than expected, particularly around the eyes and mouth, are often a result of UV damage rather than chronological aging alone. Researchers estimate that up to 80% of visible facial aging is caused by sun exposure.

Broken capillaries or visible red veins, particularly on the nose and cheeks, can result from UV-induced damage to small blood vessels near the skin's surface.

Actinic keratoses are rough, scaly patches that develop on sun-exposed skin and are considered precancerous. They can feel like sandpaper and may be pink, red, gray or brown. These should always be evaluated by a dermatologist, as a small percentage can progress to squamous cell carcinoma if left untreated.

What changes on the skin are warning signs of something more serious?

While cosmetic signs of sun damage are worth addressing, certain skin changes can indicate skin cancer and should never be ignored.

Using the ABCDE rule can help identify suspicious spots:

• Asymmetry means one half of the spot looks different from the other.
• Border irregularity refers to jagged, blurred or uneven edges.
• Color variation, including multiple shades of brown, black, red, white or blue within a single lesion, is concerning.
• Diameter larger than a pencil eraser, roughly 6 millimeters, warrants attention, though melanomas can be smaller.
• Evolution, or any change in size, shape, color or sensation over time, is perhaps the most important warning sign of all.

Beyond melanoma, basal cell and squamous cell carcinomas are far more common and often present as a pimple that does not heal, a waxy or pearly bump, a flat scar-like lesion or a rough scaly patch that persists despite moisturizer.

When should you see a dermatologist?

The American Academy of Dermatology recommends a full-body skin exam by a dermatologist at least once a year for adults, and more frequently for those with a personal or family history of skin cancer, a history of significant sun exposure or tanning bed use or fair skin that burns easily.

You should see a dermatologist promptly, without waiting for your next scheduled visit, if you notice any spot that is new and growing, any existing spot that is changing in size, shape or color, any lesion that bleeds, itches or does not heal within four to six weeks, or any rough scaly patch that persists.

Do not wait for a spot to hurt or bleed before seeking attention. Skin cancer is visible, and catching it early dramatically improves outcomes.

How can you monitor your own skin between appointments?

Monthly self-exams are one of the most effective tools for early detection. Use a full-length mirror and a hand mirror to examine all areas of your body, including the scalp, between toes, under fingernails and the soles of your feet. Using a smartphone to photograph hard-to-see areas, such as your back and the backs of your legs, can help you track changes over time.

The American Academy of Dermatology offers a free, downloadable body mole map to help patients conduct thorough self-exams at home.