Objectives: To learn how to protect the skin and to reduce the risk of photoaging and skin cancer
To learn differences between solar filters and formulations
To learn how to choose a sunscreen
To learn how to avoid common mistakes in the use of sunscreens by customers

Introduction: The incidence of skin tumors is increasing in all western countries. This phenomenon can be partly but not exclusively due to skin aging and a cultural and social behaviour leading to more sun exposures. However paradoxically this increase of incidence follows the increase of the sales of sunscreens pointing out that the wrong use of sunscreens may be more deleterious for the health than no use. In addition, some sunscreens have a poor quality and customers can not be readily identify good and bad suncreens.

Materials / method: We will clarify differences of the molecular structures of sunscreens, their mode of action, and efficacy in in vitro and in vivo conditions
We will explain the importance of the notions of SPF, UVA-PF, water resistance, stability and formulation and the common mistakes that customers and doctors do when they deal with their values and indexes.

Results: Practical suggestions will be provided.

Conclusion: A sunscreen can save the skin but, like all drugs, only if it is used properly. A bad use or bad products can be dangerous because they provide for a wrong feeling of being protected and they encourage to stay longer under the sun

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Objectives: Expose different methods of photodynamic therapy practice to treat photoaging.

Introduction: Photodynamic therapy (PDT) is an effective method to treat photoaging.

Materials / method: PDT allows both a medical action by destroying dysplastic and tumor cells, and an aesthetic action by restoring skin density and texture.

Results: We will see multiple ways to practice PDT: laser pre-treatment, conventional PDT, Day Light PDT, Light Emitting Fabrics, PDT with Artifical White Light, use of fluorometry as well as different photosensitizers that can optimize results depending on the objectives and the topography.

Conclusion: There are now other techniques besides conventional PDT to treat photoaging. As a result, the new PDT treatment methods are now well tolerated and virtually painless. The therapeutic consequences are generally simple and without risk of scarring.

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Objectives: Laser treatment, ablative and non-ablative as monotherapy or in combination can represent a meaningful treatment option in selected cases. We tried to summarize results of scientific studies prooving the effect of lasers for the Treatment of NMSC esp. BCC

Introduction: With a clear increase in the incidence and a continuously earlier onset, the Treatment options for localized resectionable basal cell carcinoma include micrographically controlled surgery, simple excision, curettage, laser ablation, nonsurgical treatment options are more suited for cases in which surgical procedures lead to disfigurement or functional impairments or for patients with a high surgical risk. Among them are cryosurgery, imiquimod, 5-fluorouracil, photodynamic treatment and radiotherapy and lasers

Materials / method: In pub med and multiple journals we searched fort he use of lasers in NMSC , esp. BCC, their paramenters and results.
Laser ablation with Er:YAG and CO2 lasers continues to be of interest as a potentially less invasive alternative to surgery for the treatment of low-risk superficial and nodular subtypes of BCCs. The lack of histopathological confirmation has been a limitation but a reflectance confocal microscopy (RCM) imaging-guided approach offers cellular-level histopathology-like feedback directly on the patient.Ablative fractional lasers (AFXL) enhance uptake of topical therapeutics a

Results: Non ablative laser procedures can also be effective, easy to perform and inexpensive as well as associated with little side effect and almoast no downtime.
Pulsed dye lasers (PDL) produce intravascular thrombus formation without epidermal and dermal damage; histological studies immediately after treatment show agglutinated red blood cells, fibrin and platelet thrombin confined to the blood vessels of the papillary and mid reticular dermis, BCC is a vascular dependent lesion, hence the utility of PDL Treatment The Nd:YAG (1064 nm) laser is more highly absorbed in blood than in the surrounding

Conclusion: There already is increasing evidence about the effects of laser treatment of basal cell carcinoma; nevertheless, further studies with a high level of evidence are necessary.

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Objectives: • Background on actinic keratoses in sun damaged skin
• Overview of treatment options for actinic keratoses
• Comparison of topical treatment for actinic keratoses
• Prevention of actinic keratoses in photodamaged skin

Introduction: Actinic keratoses is the most frequent premalignant skin disease in the white population and is caused by exposure to ultraviolet radiation. Actinic keratoses are atypical keratinocytes in epidermis and has the potential to progress into an invasive squamous cell carcinoma. Patients with actinic keratoses often present with multiple lesions in one continuous area (field cancerization). Due to the lack of prognostic tools concerning the determination of lesions at risk of progression treatment of actinic keratoses are presumed to be necessary.

Materials / method: The choice of treatment for actinic keratoses depends of the number of lesions, the distribution of the lesions, if the patient is immunosuppressed or not and the preference of the patient/physician. Treatment options for actinic keratoses is cryotherapy, curettage, 5-fluorouracil, imiquimod, conventional and daylight photodynamic therapy and ingenol mebutate. In high risk patients chemoprevention of non-melanoma skin cancer should be considered such as sunscreens, prophylactic treatments with 5-fluorourasil, photodynamic therapy and nicotinamide.

Results: In a Dutch multicenter study 624 patients with at least 5 actinic keratoses in a continuous area on the head were randomized to either 5% 5-fluorouracil cream, 5% imiquimod cream, photodynamic therapy or 0.015% ingenol mebutate. At 12 months after end of treatment the probability to have at least 75% reduction in actinic keratoses lesion count was higher among patients treated with 5% 5-fluorouracil (75%) compared to 5% imiquimod (54%), photodynamic therapy (38%) and ingenol mebutate (29%). No significant difference in adverse events was found between the 4 treatments.

Conclusion: Several effective treatments for actinic keratoses are available however the recurrence rate after treatment is high often leading to repetitive treatments. Besides clinical efficacy the required treatment duration, adherence of patients overly complex treatment regimes, compliance of frail patients to treatments with side effects and uncertainty as to the exact lesion area to be treated should also be considered during planning of the treatment.

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