Are you seeing spots – on parts of your body that used to be free of blemishes? Small dark patches that appear on healthy skin have many names, including age spots, liver spots, solar lentigines, and solar lentigo. The good news is that they pose no health risk. But many people find them embarrassingly unattractive.
Age spots typically appear on skin that gets a lot of sun exposure such as the face, hands, shoulders, and arms. The odds of developing this medical condition increase after age 50 – hence the name.
A natural pigment called melanin is what colors skin. The body naturally produces more melanin after exposure to UV (ultraviolet) light, causing the skin to tan.
Age spots arise when melanin becomes clumped in the skin or is secreted in high concentrations from high levels of UV light exposure whether it comes from the sun or a tanning bed lamp (bulb or tube).
Age spots share some common characteristics. They are flat, oval areas of increased pigmentation, usually tan, brown or black, and occur on skin that has had the most sun exposure over the years – the backs of the hands, tops of feet, face, shoulders, and upper back.
Not all age spots are the same, though. Freckles are flat, smaller, and light brown. Flat, dark and better-formed spots are called lentigines (or lentigo if there is only one of them). Thicker spots that are flesh-colored, pink, light brown or dark brown, and may resemble barnacles might be harmless overgrowths on the top layer of skin called seborrheic keratoses.
Protection from sunlight and UV radiation may improve and prevent freckles and lentigines but will not ward off seborrheic keratoses.
These darkened areas of skin can be covered with cosmetic creams and lotions or removed through professional procedures. They form on all shades of skin but are more noticeable on fair complexions.
Freckles and lentigines can be treated with liquid nitrogen, different laser and intense pulsed light therapies, chemical peels or topical bleaching creams.
Seborrheic keratoses can be treated with liquid nitrogen when they are relatively flat. Thicker spots must be scraped off by a dermatologist (skin specialist) after a local anesthetic is administered to numb the pain.
Because seborrheic keratoses look like cancerous melanomas, experts recommend getting a professional opinion to make sure they are benign.
For those who want to fade age spots quickly, procedures that involve lasers or chemical peels are usually the way to go. But expect to pay more and possibly experience unwanted side effects.
Laser and intense pulsed-light therapies target melanin granules and melanin-producing cells (melanocytes) without damaging the skin’s surface.
While more affordable, creams and lotions applied directly to the darkened skin require some micro-management – we’re talking about one or two daily applications over the course of weeks or months to see results.
There are many products sold over-the-counter (without a prescription) that claim to get rid of unsightly skin spots. Select a non-prescription fade cream that contains hydroquinone, glycolic acid or kojic acid – but note that some of these products, especially those with hydroquinone, may cause skin irritation.
Always read the ingredients list and NEVER USE ANY PRODUCT THAT CONTAINS MERCURY, a known toxin that can cause serious health problems.
Seeing a professional dermatologist may cost more up-front but pay off in the long run. These experts know the products that are available for an individual’s condition. They can prescribe a stronger skin-lightening cream when appropriate.
Prescription-strength lightening creams (hydroquinone) used alone or with vitamin A-based drugs called retinoids (tretinoin) and a mild steroid may gradually fade the spots over several months.
Scientific research has shown that prescription-strength cream used for a longer time is just as effective as one or two laser treatments to lighten age spots significantly. Temporary crusting or darkening of age spots is a known side effect of laser therapies that can be avoided by using topical creams.
Cryotherapy uses liquid nitrogen, administered by a dermatologist, to injure the skin cells in the age spots by freezing them. The treated skin lightens as it heals but be prepared for some pain, a blister or short-term redness and swelling. Cryotherapy may permanently darken the age spot, lighten the skin that borders the age spot (creating a light ring) or leave a scar.
Microdermabrasion is a procedure dermatologists use to mechanically smooth age spots. This technique can be very effective, especially when paired with a chemical peel that contains an acid strong enough to remove the outer layer of skin.
Patients in one study were treated either with microdermabrasion or microdermabrasion and a chemical peel once every 2 weeks for 16 weeks. The age spots in about 40% of the patients in the first group vanished completely, compared to a success rate of 50% in the second group. Flaky skin that lasted 3 or 4 days and mild reddening of the treated skin that disappeared after a few hours are associated with this office procedure.
Left untreated, age spots will probably persist indefinitely. Some experts say that bleaching agents such as hydroquinone are not effective. When in doubt, consult a skin-care professional for a “spot-on” assessment and treatment plan.