ConditionSkin, hair & nails
Age Spots (Liver Spots)
Age spots are flat, tan to dark brown spots that appear on skin that has had years of sun exposure, such as the face, backs of the hands, shoulders and forearms. They are harmless collections of pigment and are very common after age 50. They have nothing to do with the liver, despite the old name "liver spots." A spot that is changing, irregular or multicolored should be checked, because melanoma can look similar.
Also called: Liver spots, sun spots, solar lentigines, senile lentigo, lentigo solaris
At a glance
- What they are
- Flat, well-defined brown spots from sun-stimulated pigment cells.
- Where
- Face, backs of hands, forearms, shoulders, upper back.
- Who
- Mostly people over 40 to 50 with lighter skin and a history of sun exposure.
- Harmful?
- No, but they show sun damage and must be told apart from melanoma.
- Treatment
- Optional: lightening creams, chemical peels, freezing or laser.
- Prevention
- Daily broad-spectrum sunscreen and sun protection.
When to get help
See a doctor within a day or two
- A spot that is growing quickly, bleeding, itching or changing shape or color
- A new dark spot that looks different from all your other spots (the "ugly duckling" sign)
Book a routine appointment
- A spot with an irregular border, more than one color, or wider than about 6 mm (1/4 inch)
- A dark spot on the face that keeps enlarging slowly
- Wanting an annual skin check if you have many spots, fair skin, or a family history of melanoma
Usually safe to manage at home
- Stable, uniform, flat light-brown spots that have been present for years and match your other spots
What causes age spots
Ultraviolet (UV) light from the sun and tanning beds stimulates pigment cells (melanocytes) to make more melanin. After years of exposure, pigment collects in clusters and the number of melanocytes in that area increases, forming a flat spot. They become more common with age because sun damage accumulates.
Risk factors:
- fair skin and hair that burns easily
- years of outdoor work, sports or sunbathing
- frequent sunburns
- tanning bed use
- certain light treatments (PUVA)
What age spots look like
- flat and oval or round
- tan, light brown or dark brown, evenly colored
- usually 3 mm to 2 cm across, sometimes merging into larger patches
- sharp edges
- on sun-exposed skin
They do not itch or hurt, and they may darken in summer.
Age spots vs other spots
| Spot | Features |
|---|---|
| Age spot (solar lentigo) | Flat, uniform brown, sharp edges, sun-exposed skin |
| Freckles | Small, light brown, appear in childhood, fade in winter |
| Seborrheic keratosis | Raised, waxy, "stuck-on" look, brown to black |
| Actinic keratosis | Rough, scaly, pink or tan patch. Precancerous |
| Melasma | Larger symmetrical patches on the cheeks, forehead or upper lip, linked to hormones |
| Melanoma | Irregular, multicolored, changing, may be raised. Needs urgent assessment |
| Lentigo maligna | A slowly growing, irregular, unevenly dark patch on the face of older adults. An early form of melanoma |
The ABCDE warning signs
Use this checklist for any brown spot:
- Asymmetry: one half does not match the other
- Border: ragged, notched or blurred
- Color: several shades of brown, black, red, white or blue
- Diameter: larger than 6 mm, though melanomas can be smaller
- Evolving: changing in size, shape, color or symptoms
Any of these warrants a visit to a dermatologist. See skin cancer screening for what a skin check involves.
Diagnosis
A dermatologist can usually diagnose age spots by looking at them with a dermatoscope, a lighted magnifier that shows pigment patterns. If a spot looks atypical, a biopsy (a small sample under local anesthetic) is taken to rule out lentigo maligna or melanoma. Spots should be checked before any cosmetic treatment, because treating an undiagnosed melanoma can delay diagnosis.
Treatment and removal
Treatment is cosmetic and optional.
- Prescription lightening creams: hydroquinone, often with a retinoid (tretinoin) and a mild steroid, applied for several months. They can irritate the skin.
- Over-the-counter products: containing azelaic acid, niacinamide, vitamin C, kojic acid or glycolic acid. Results are modest and slow.
- Cryotherapy: freezing individual spots with liquid nitrogen. It can leave lighter or darker patches.
- Laser and intense pulsed light (IPL): target pigment and often work in 1 to 3 sessions.
- Chemical peels and microdermabrasion: remove the outer skin layer.
All treatments work best with strict sun protection. Without it, spots return. People with darker skin have a higher risk of uneven pigmentation after treatment and should see an experienced dermatologist.
Prevention
- use broad-spectrum sunscreen with SPF 30 or higher every day on exposed skin, reapplying every 2 hours outdoors
- wear a wide-brimmed hat, sunglasses and long sleeves
- seek shade between 10 a.m. and 4 p.m.
- avoid tanning beds
Frequently asked questions
What causes age spots?
Age spots are caused by years of exposure to ultraviolet light from the sun or tanning beds, which makes pigment cells overproduce melanin in clusters. They are more common with age, fair skin and a history of sunburn. They are not caused by liver problems.
Are age spots dangerous?
No. Age spots are harmless and do not turn into cancer. However, they are a sign of sun damage, and melanoma can look similar. Any spot that is irregular, multicolored, larger than a pencil eraser or changing should be checked by a dermatologist.
How do you get rid of age spots?
Options include prescription lightening creams such as hydroquinone, chemical peels, freezing with liquid nitrogen and laser or intense pulsed light treatments. Daily sunscreen is essential to stop spots returning. Have spots checked before treatment.
Can age spots fade on their own?
Age spots rarely disappear completely on their own, though they may lighten in winter and with strict sun protection. Over-the-counter fade creams can lighten them slightly over months. Professional treatments are more effective.
What is the difference between age spots and liver spots?
There is no difference. "Liver spots" is an old name based on the mistaken idea that the liver caused them, or on their liver-like color. Doctors call them solar lentigines.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Age spots, how to get rid of them
- MedlinePlus: Aging changes in skin
- Mayo Clinic: Age spots (liver spots)
- Skin Cancer Foundation: The ABCDEs of Melanoma
- NHS: Melanoma skin cancer