A striking image of a 69-year-old truck driver shows just how much damage the sun can do.

This photograph, published in the New England Journal of Medicine, shows what dermatologists call dermatoheliosis — sun damage, a common sign of aging. What makes it striking is that this man, a retired truck driver, shows the damage on only one side of the face.

“He was a truck driver for the majority of his life and never wore sunscreen,” said Northwestern University dermatologist Jennifer Gordon, who reported the man’s case. “We think the sun exposure just on this side of the face is what caused the damage.”

Ultraviolet A (UVA) light from the sun can easily penetrate window glass and even light clothing, Gordon told LiveScience. UVA rays cause damage deep in the skin, affecting connective tissues such as collagen and elastin.

“That’s where you get that aging effect: the wrinkles, the deposits of material in the skin,” Gordon said.

The patient in the photograph came to Gordon and her colleagues after he got tired of his grandchildren asking him what was wrong with one side of his face. So far, the man has not exhibited any signs of skin cancer, Gordon said, though he’ll need to be monitored carefully in the future.

“This article gives a visual depiction of the deleterious effects that the sun can have on your skin with continuous exposure; causing damage leading to skin cancers, skin thickening giving a leathery appearance and loss of elasticity resulting in sagging and wrinkles.  The current recommendation for sunscreen use by dermatologists is a sunscreen that covers both UVA and UVB with an SPF of at least 30 with re-application cycles of approximately 2 hours in situations with continuous long term sun exposure.”

Tonya McLeod MD, MPH, MBA