Age Spots are also known as liver spots but their medical name is solar lentigines. They are light brown to dark brown patches found on sun-exposed skin. The spots can be round, oval or even irregular in shape. They will have well-defined borders and consistency in color. Age spots can range in size from a couple of millimeters to about a half-inch. Some may form together to look like larger lesions. Solar lentigos are benign lesions caused by exposure to UV light including tanning beds.
Solar lentigos are very common in people older than 40 and more common in the Caucasian population but often seen in Fitzpatrick III and IV patients such as native American, Asian and Latino skin. African American skin tends not to form age spots because the increased melanocytes and pigmentation give them some have some protection. Studies show that as high as 90 percent of Caucasians over the age of 60 will be affected by solar lentigos.
It is very important to evaluate the lesions before any treatment. Age spots are a sign of significant sun exposure which is the number 1 risk for skin cancer. Solar lentigos that are changing in shape, size, color or become inflamed should be biopsied as that could be a sign of malignancy.
- Sun Avoidance – It is best to avoid being outside from 10:00 am to 3:00 pm. This is the time of day when the UV rays from the sun are the strongest.
- Sunblocks like EltaMD should be applied daily even in the winter. We recommend sunblocks with at least SPF 30 and apply every two hours while outside.
- Wear protective clothing – this would include long sleeve shirts, long pants and a broad-brimmed hat while exposed to the sun.
- Shade – We all know that we want to be outside as much as possible with our short summers in the Midwest. Instead of hanging out in the direct sunlight hang out in the shade of trees or under a covered area.
- Skin lightening creams – there are many choices out there that are over the counter and do not work very well. We have found that prescription-strength Obagi NuDerm System and the ZO Skincare line work very well on facial lentigos.
- Cryotherapy – freezing the lentigos can destroy the lentigo but has some risk of scarring and leaving a white depigmented area of the skin. Cryotherapy is not as precise as lasers.
- Chemical peels – may lighten the lentigos but will not remove them completely.
- Intense pulsed Light – Our choice of IPL is the BBL by Sciton. We feel that it is the gold standard IPL system. It can individually treat age spots or can be used on all areas of the skin including the hands and arms.
- Fractional Lasers – these include the Halo, Fraxel, DeepFX and Active FX. These will likely require more than one treatment but are an excellent adjunct to topical treatment. This is an excellent choice when treating larger areas.
- Q-Switched lasers – We use the Lutronic Spectra laser for the treatment of individual spots and may give better long-term improvement than the BBL.
- Ablative lasers – these include the Ultrapulse CO2 laser and the Erbium laser. We prefer to use the Erbium laser for treating individual lentigos as it has less risk of causing permanent pigmentation changes to the skin. If a patient has a lot of facial solar lentigos that are benign, then it may be best to go ahead and completely resurface the skin on the face.
Age spot treatments are considered cosmetic and it is unlikely your insurance will pay for treatment. Make sure that any treatment you have is provided by someone with significant experience working with the skin.