AGE SPOTS (LIVER SPOTS)

Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes

Age spots are flat brown, gray, or black spots on the skin. They usually occur in sun-exposed areas, like the backs of the hands and the face. Age spots are also called liver spots, senile lentigo, solar lentigines, or sun spots.
It’s not uncommon for a single age spot to appear, or for a few to cluster together.
While they may begin developing at an early age, and even during childhood, they’re most common in middle age and older adulthood, especially if persons spend a lot of time in the sun.
The good news: Age spots aren’t cancerous, and they don’t develop into cancer, either.

RISK FACTORS
While anyone can develop age spots, they tend to show up more commonly in people with certain risk factors. These include:
• Older than 40 years
• Having fair skin
• A history of frequent sun exposure
• A history of frequent tanning bed use

CAUSES
Age spots typically happen due to excess production of melanin, or skin pigment. Experts don’t know exactly why age spots develop, but some people do have a hereditary predisposition to them. Other possible causes include skin aging, ultraviolet (UV) light exposure, such as tanning beds, and sun exposure. That’s why it is most likely to develop age spots on areas of the skin that receive the most sun, such as the face, backs of the hands, shoulders, upper back, and forearms

SYMPTOMS
The main symptoms that characterize age spots include:
• Color. Age spots range from light brown to black. They may darken after time in the sun.
• Texture. The spots have the same texture as the rest of the skin. They typically appear in sun-exposed areas. They’re flat to the touch and don’t cause any pain.
• Size. Age spots can vary from the size of a very small freckle to an inch in diameter.
• Grouping. They may appear on their own or in a group, which can make them more noticeable.
• Shape. Age spots are typically round or oval, with very defined edges.

DIAGNOSIS
A dermatologist or healthcare professional will usually diagnose age spots with a visual inspection, a biopsy, or both.

TREATMENT
Age spots don’t cause any health problems, so treatment typically isn’t necessary. Options for treatment include the following.
• Prescription medications
A dermatologist may prescribe bleaching creams to help fade the age spots gradually. These creams usually contain hydroquinone and sometimes retinoids, such as tretinoin.
• Medical procedures
Several medical procedures can remove or reduce age spots, but these procedures do carry some risk of side effects and complications. Medical procedures for age spots include:
• Intense pulsed light (IPL) treatment.
• Chemical peels.
• Dermabrasion.
• Cryosurgery.
• Laser treatment.
• Microdermabrasion.
While it’s important to wear sunscreen every day, it’s essential to wear sunscreen after any skin treatments or procedures. Sunscreen protects the healing skin from UV damage, but it also helps prevent age spots from returning.

OVER-THE-COUNTER TREATMENTS
If persons want to use an OTC cream, opt for one that contains one of the following ingredients:
• Deoxyarbutin
• Glycolic acid
• Alpha hydroxy acid
• Kojic acid
Cosmetics don’t remove age spots, but they can certainly help cover them

PREVENTING AGE SPOTS
While persons can’t always prevent age spots, they can take a few steps to help lower the chances of developing them:

• Avoid the sun between 10 a.m. and 4 p.m., when the sun’s rays are most intense.
• Wear sunscreen every day. It should have a sun protection factor (SPF) rating of at least 30 and contain both UVA and UVB protection.
• Apply sunscreen at least 30 minutes before sun exposure. Reapply every 2 hours, and more often if swimming or perspiring.
• Wear protective clothing, such as hats, pants, and long-sleeved shirts. This help protects the skin from UV rays. For the best protection, wear UV-blocking clothes with an ultraviolet protection factor (UPF) of at least 40.
Age spots are harmless changes to the skin that don’t cause pain. In some cases, though, their appearance could cause some emotional distress or even concerns about skin cancer. If persons noticed any changes in the age spots or would like to try having them lightened or removed, a healthcare professional or dermatologist can examine the spots and offer more guidance about the options for treatment.