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Age Spots and How to Treat Them


Age spots, also known as liver spots and solar lentigines, are areas of increased pigmentation on the face, hands, shoulders, tops of feet, or arms that are not cancer, but they sure are not attractive either. What causes age spots and how can you treat them?

What Causes Age Spots?
The main cause of age spots is exposure to ultraviolet light, which speeds up production of the dark pigment called melanin. Although a normal amount of melanin gives skin its normal color, extra pigment is produced with prolonged exposure to ultraviolet light, allowing slow accumulation over time. Age spots develop when the extra melanin collects in the skin or is produced in higher concentrations than normal.

Age spots are also the result of growing older, which can trigger extra production of melanin. Susceptibility to developing age spots can also be inherited.

Identifying Age Spots
Age spots typically appear on sun-exposed skin, are more common in people who have a fair complexion, and are usually brown, black, or gray. Sizes range from freckle-size to more than a centimeter across, and they may appear alone or group together. Because age spots are related to sun exposure, they are often accompanied by other signs of sun damage, including wrinkles, dry rough skin, translucent skin, and fine red veins on the nose, ears, and cheeks.

A doctor can diagnose age spots by inspecting your skin. If the doctor is uncertain, a biopsy can be done. Other conditions can resemble age spots, including moles. These skin conditions are usually small and dark brown, and they can be flat or raised. Moles tend to vary in color and size, and they may become darker with repeated exposure to the sun or during pregnancy.

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Seborrheic keratoses also resemble age spots. These skin growths may be tan, brown, or black and have a waxy, wart-like appearance. They range in size from tiny to more than 1 inch in diameter. Lentigo maligna, a type of skin cancer, can also develop as a result of sun exposure. Lentigo maligna starts as brown, black, or tan lesions that gradually become darker and larger. They often have uneven coloring, irregular borders, and are flat or slightly raised.

Treating Age Spots
Age spots are harmless, but some people want to lighten or remove them for cosmetic reasons. During treatment, minimize exposure to the sun. Use a sunscreen with at least a 15 sun protection factor rating after consulting with your doctor.

Treatment of age spots can include use of bleaching and fading creams. These products are available either by prescription (hydroquinone, tretinoin) or over-the-counter (OTC; contain glycolic acid or kojic acid). Prescription medications may gradually fade the spots over several months, while OTC products are generally less effective. A new study (October 2009) has found a new depigmenting agent, undecylenoyl phenylalanine 2%, to significantly lighten age spots, but the substance is not yet on the market.

Laser treatments are another approach. Several laser treatments are usually needed to destroy the extra melanocytes that create the dark pigment. Once treatments are done, age spots fade gradually over weeks or months. Some people choose freezing, which involves the use of liquid nitrogen or another freezing agent, which is applied to destroy extra pigment. There is a slight risk of permanent scarring or discoloration.

A technique called dermabrasion involves removing the surface layer of the skin using a rapidly rotating brush. Redness and temporary scabs may develop. A chemical peel requires the application of an acid that burns the outer layer of skin. As the skin peels, new skin forms to replace it.

Any age spot treatment techniques should be performed by a dermatologist who is specially trained in the methods. Because age spot removal is considered a cosmetic procedure, insurance usually will not pay for it.

American Academy of Dermatology
Katoulis AC et al. Clinical and Experimental Dermatology 2009 Oct 23.
Mayo Clinic