Age spots

Age spots, which are also called liver spots or solar lentigines, are flat, oval spots that appear on areas of your body that are most exposed to the sun - the face, backs of the hands, tops of the feet, shoulders, upper back, and arms. Age spots vary in size and can be tan, brown, or black in color.

Age spots are very common in adults older than age 50. But, younger people can get them too, especially if they spend a lot of time in the sun. Age spots typically develop in people with fair complexions, but people with darker skin can also get them. While age spots are sometimes called “liver spots,” they have nothing to do with the liver or liver function.

Age spots can look like cancerous growths, but true age spots are harmless and do not require treatment. For cosmetic reasons, age spots can be lightened with skin-bleaching products or removed. However, you can maintain your skin's youthful appearance by preventing age spots by avoiding the sun and using sunscreen.

Age spots can look like cancerous or precancerous growths, so is it important to always let your health care provider know if you have any new or unusual spots and have them checked.

Age spots appear as a patch or area of skin color change that is:

• flat
• light brown to black
• painless

Cancerous and precancerous lesions, on the other hand, may have many different appearances. Spots or sores related to skin cancers can be:

• small, shiny, or waxy
• scaly and rough
• firm and red
• crusty or bleeding

Age spots are caused primarily by years of exposure to ultraviolet (UV) light from the sun. The use of commercial tanning lamps and tanning beds can also contribute to the development of age spots.

The pigment in the upper layer of skin (epidermis) that gives your skin its normal color is called melanin. UV light accelerates the production of melanin, creating a tan that helps protect deeper layers of skin from UV rays.

Age spots appear when melanin becomes "clumped" or is produced in particularly high concentrations, such as on areas of the skin that have years of frequent and prolonged sun exposure.

Some people have a hereditary predisposition to age spots. Age spots may develop at an early age, even in childhood, though they are more common in older people, especially in those who have spent too much time in the sun.

Your doctor will diagnose age spots on the basis of how your skin looks, especially if you are over 40 and have had a lot of sun exposure. You may need a skin biopsy to confirm the diagnosis if you have a liver spot that looks irregular.

Liver spots are not dangerous to your health. They are permanent skin changes that simply affect how your skin looks.

Many creams and lotions are available for lightening age spots. These may improve the appearance of age spots, depending on how dark the spots are and how often you apply the cream or lotion. Regular use over several weeks or months may be necessary to produce noticeable results. Many over-the-counter (nonprescription) fade creams contain hydroquinone, glycolic acid, or kojic acid. Some of these products may cause skin irritation. Ask your doctor or pharmacist for advice on choosing a lightening cream.

Call your healthcare provider if you have liver spots and want them removed or if you develop any new symptoms, especially changes in the appearance of a liver spot.

Preventing age spots by being safe in the sun is the best way to maintain your skin’s healthy appearance.

Protect your skin from the sun by covering your skin with clothing such as hats, long-sleeved shirts, long skirts, or pants when you must be outdoors; using sunglasses to protect your eyes; avoiding the sun at midday, when sunlight is strongest; and using high-quality sunscreens that have an SPF rating of at least 30. Apply sunscreen at least a half hour before you go out in the sun and reapply it often. Use sunscreen in the winter, too.

Most of the time, no treatment is needed for age spots. However, you can improve the appearance of your skin by using skin bleaching lotions or creams. Most bleaching lotions use hydroquinone. This medicine is thought to be safe in the form used to lighten darkened skin areas. However, hydroquinone can cause blisters or skin reactions in some people. See your healthcare provider before starting treatment if you are concerned.

You may choose to treat age spots to improved your appearance, enhance self-esteem, or promote better skin health.

Age spot treatments include:

• medications. Prescription bleaching creams (hydroquinone) used alone or with retinoids (tretinoin) and a mild steroid may gradually fade the spots over several months.
• laser and intense pulsed light therapy. Laser and intense pulsed light therapies destroy melanin-producing cells (melanocytes) without damaging the skin's surface. Treatments with a laser or intense pulsed light typically require several sessions. After treatment, age spots fade gradually over several weeks or months.
• freezing (cryotherapy). This procedure involves applying liquid nitrogen or another freezing agent to the age spots to destroy the extra pigment. As the area heals, the skin appears lighter. Freezing is typically used on a single age spot or a small grouping of age spots.
• dermabrasion. This procedure consists of sanding down (planing) the surface layer of your skin with a rapidly rotating brush. This procedure removes the skin surface, and a new layer of skin grows in its place. Temporary redness and scab formation can result from this treatment.
• chemical peel. A chemical peel involves applying an acid, which burns the outer layer of your skin, to the age spots. As your skin peels, new skin forms to take its place. Several treatments may be necessary before you notice any results.

All of these treatments may temporarily irritate the skin and cause discomfort. These treatments may also cause permanent skin discoloration. Sun protection is recommended while you are receiving any of these treatments.