To determine the prevalence of premature ageing of the skin and to assess its associations with skin cancer and related risk factors in a Queensland population. Community-based prevalence survey of skin cancer and actinic skin damage. Population of Nambour, Queensland, in December 1986. Random sample of 1539 residents aged 20 to 55 years for whom skin texture measurements were obtained, and a subsample of 807 whose skin reflectance was measured. Associations of premature ageing of exposed skin, assessed by silicone moulds of the dorsal skin of the hand, with present or past skin cancer, skin colour measured by reflectance and other related risk factors. Skin texture changes consistent with moderate to severe ageing were observed in 72% of men and 47% of women under 30 years of age. Severity of skin ageing was significantly associated with increasing age, and independently, with the presence of solar keratoses (P less than 0.01) and skin cancer (P less than 0.05). Increased deterioration was also correlated with decreasing reflectance (darker colour) of sun-exposed skin in both men (P less than 0.01) and women (P less than 0.05), but not with reflectance from sun-protected skin, that is inherent skin colour. Photoageing among men was associated with outdoor occupations, outdoor leisure activities, a tendency to sunburn and previous skin cancer. Marked premature ageing of exposed skin is common in residents of Queensland and is evident among adults in their twenties. Public education programs about the ill-effects of excessive sun exposure should emphasise not only the risk of skin cancer, but also the high risk of premature skin ageing.