Changes occur to skin from chronic exposure to UV radiation (different from age related changes to skin). Histological changes vary from benign hyperplasia to epidermal dysplasia; white elastic fibres thicken and increase in number; collagen is degraded and damaged by long term exposure. The process is initial characterised by an accumulation of abnormal tissue  progresses to atrophic state in the elderly.

Clinical features:
Wrinkling and roughness of skin; irregular mottled pigmentation (from melanocytic hyperplasia); brown macules; telangiectases
If more severe  red dysplastic areas of actinic keratoses (greater risk of neoplasia)

Photodamage is cumulative  prevention starts at young age.
Older persons who have taken preventative measures younger generally look younger than their chronological age.

4-6 months of topical tretinoin helps.
Plastic/cosmetic surgery

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