A healthy looking tan is in fact just the opposite. It is skin that has been damaged. The skin produces melanin as a natural sunscreen to try and protect the skin cells against further damage. This damage shows up as “age spots”, freckles, discoloration or uneven skin color, wrinkles and skin cancer.
| Photo-aging Group | Age Group | Characteristics |
| 1 – Mild | Typically ages 28-35 | Minimal wrinkling or scarring Mild or no keratoses Minimal or no makeup |
| II – Moderate | Ages 35-50 | Early wrinkling; mild scarring Sallow color with early actinic keratoses Little makeup Early to moderate photoaging Early senile lentigines visible Keratoses palpable but not visible Parallel smile lines beginning to appear |
| III – Advanced | Ages 50-65 | Persistent wrinkling or moderate acne scarring Discoloration with Telangiectasias and actinic keratoses Always wears makeup Yellow – gray skin color Prior skin malignancies |
| IV – Severe | Ages 60-75 | Wrinkling; severe photo-aging, gravitational, and dynamic Actinic keratoses with or without skin cancer Wrinkles throughout, no normal skin Severe acne scaring Wears makeup but doesn’t cover imperfections well or Makeup cannot be worn- it cakes and cracks |