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Mathison: This picture of sun damage worth a thousand words

This photo of a 69-year-old man shows the dramatic difference in skin's texture due to skin damage on the left side of his face from sunlight through his delivery truck window. (The New England Journal of Medicine)

You may have enjoyed a day of sun and fun yesterday, and hopefully there are many more in store this summer. And I hope that you protected your skin with a hat, sunglasses and a few healthy shots of sunscreen, liberally applied. But what about everyday exposure? We don't really risk a sunburn every day, so daily sunscreen application is not the norm.

The 69-year-old man in this photo (above) drove a delivery truck in the Chicago area for 28 years. He came in to be checked for a history of gradual thickening and wrinkling of the skin on the left side of his face. Findings were consistent with photodamaged skin, known as dermatoheliosis. Many people aren't aware that ultraviolet A (UVA) rays transmit through window glass, affecting the epidermis and upper layers of dermis and causing destruction of elastic fibers. He truly is a time traveler, giving us a look into our skin's potential future.

I've never seen differences to this extreme, but I do find that there are usually a few more wrinkles on my patients' left sides due to driving, and that the left also needs more filler when I do plumping injections.

My analogy is that the skin has a "Jello" layer, leading to soft, smooth supple skin when we are kids and young adults. Over time, that Jello layer melts away, leaving us with thinner, less radiant skin that is prone to spots, prominent blood vessels and wrinkles from underlying muscle movement. This process speeds up due to lifestyle factors including smoking, alcohol use, chronic stress and of course, sun exposure.

I always think of it as UVA = aging and UVB = burning. Until recently, many sunscreens lacked full-spectrum coverage and contained UVB blockers only. Although exposure to ultraviolet B (UVB) rays is linked to higher rates of skin cancer, UVA has also been shown to induce DNA damage and direct toxicity, and can lead to skin cancer. This lack of UVA coverage in the past is likely why we are still seeing skin cancer rates rise, despite sunscreen use in the past. With broader spectrum sunscreens, and more knowledge, hopefully these trends will reverse.

Dr. Susan Mathison founded Catalyst Medical Center in Fargo and created