ConditionSkin, hair & nails
Solar Lentigines (Age Spots)
Solar lentigines (singular: solar lentigo) are flat, tan to dark brown spots caused by years of sun exposure. Often called age spots, sun spots or liver spots, they appear on the face, backs of the hands, forearms, shoulders and upper back, usually after age 40. They are harmless and are a sign of sun damage, not liver disease. Any spot that is changing, irregular, very dark or multicolored should be checked to rule out melanoma. Cosmetic options include bleaching creams, freezing and laser.
Also called: Age spots, liver spots, sun spots, solar lentigo, senile lentigo, actinic lentigo
At a glance
- What they are
- Flat, well-defined brown spots caused by cumulative ultraviolet exposure.
- Who gets them
- Adults over 40, especially with fair skin and a history of sun exposure or tanning beds.
- Where
- Face, backs of hands, forearms, shoulders, upper back.
- Are they dangerous?
- No, but they mark sun damage and raise awareness of skin cancer risk.
- Treatment (optional)
- Hydroquinone or retinoid creams, cryotherapy, laser and intense pulsed light, chemical peels.
- Prevention
- Daily broad-spectrum sunscreen, protective clothing, shade.
When to get help
Book a routine appointment
- A spot that is changing in size, shape or color, or looks different from your other spots
- A spot with irregular, blurred or notched edges, more than one color, or larger than about 6 mm (a pencil eraser)
- A spot that itches, bleeds, crusts or becomes raised
- A new dark spot on the face in an older adult that is slowly spreading (possible lentigo maligna)
- A yearly skin check if you have many sun spots, a history of skin cancer or heavy sun exposure
Usually safe to manage at home
- Stable, evenly colored, flat brown spots that look like your others, while you protect your skin from the sun
What causes solar lentigines
Ultraviolet (UV) light stimulates pigment cells (melanocytes) to make more melanin, the brown pigment that protects the skin. Over years of exposure, melanocytes in sun-damaged areas increase in number and produce excess pigment, which forms a fixed, flat spot. Unlike freckles, solar lentigines do not fade in winter.
Risk factors:
- age over 40
- fair skin that burns easily
- frequent or intense sun exposure, including outdoor work and sports
- tanning beds
- PUVA light therapy
What they look like
- flat (not raised)
- tan, brown or dark brown
- oval or round with clear edges
- from a few millimeters to about 2 cm
- often multiple, sometimes merging
- on sun-exposed areas
Age spots vs other spots
| Spot | Features |
|---|---|
| Solar lentigo | Flat, uniform brown, sharp edges, sun-exposed skin |
| Freckle | Smaller, lighter, appear in childhood, fade in winter |
| Seborrheic keratosis | Raised, waxy, "stuck-on" appearance; can start as a flat lentigo |
| Melasma | Larger, symmetrical patches on the face, linked to hormones |
| Actinic keratosis | Rough, scaly, pink or tan; precancerous |
| Lentigo maligna | Slowly enlarging, irregular, multicolored patch on the face; early melanoma |
| Melanoma | Asymmetrical, irregular border, varied colors, growing or changing |
The ABCDE warning signs
- Asymmetry: one half does not match the other
- Border: irregular, ragged or blurred
- Color: several shades, black, blue, red or white
- Diameter: larger than about 6 mm
- Evolving: changing in size, shape, color or symptoms
Any spot with these features needs a dermatologist's review.
Diagnosis
A doctor or dermatologist usually recognizes solar lentigines on sight. A dermatoscope (a magnifying light) helps distinguish them from melanoma. A biopsy is done if a spot is atypical, changing or uncertain, especially before any cosmetic treatment such as laser, which could otherwise hide an early melanoma.
Treatment
Treatment is cosmetic and optional.
- Topical lightening creams: hydroquinone, often combined with a retinoid (tretinoin) and a mild steroid; works over months
- Retinoids alone, azelaic acid or other brighteners
- Cryotherapy: freezing with liquid nitrogen; can lighten spots but may leave light patches, especially on darker skin
- Laser treatment (Q-switched or picosecond lasers) and intense pulsed light (IPL): often effective in one to a few sessions
- Chemical peels and microdermabrasion
- Over-the-counter fade creams have modest effects
Spots often return without strict sun protection.
Prevention
- broad-spectrum sunscreen SPF 30 or higher daily on exposed skin, reapplied every 2 hours outdoors
- wide-brimmed hats, sunglasses and UV-protective clothing
- shade, especially between 10 a.m. and 4 p.m.
- avoid tanning beds
Frequently asked questions
What are solar lentigines?
Solar lentigines are flat, brown spots caused by years of sun exposure. They are also called age spots, sun spots or liver spots. They are harmless and most common on the face, hands, forearms and shoulders after age 40.
Are age spots a sign of liver problems?
No. The name "liver spots" comes from their color, not from any link to the liver. They are caused by sun exposure.
How can I tell an age spot from melanoma?
Age spots are flat, evenly colored, with smooth edges, and stay stable. Melanoma is often asymmetrical, with irregular edges, multiple colors, larger size or changes over time. Have any changing or unusual spot checked.
How do you get rid of age spots?
Options include prescription lightening creams with hydroquinone and retinoids, freezing, laser or intense pulsed light treatment, and chemical peels. Daily sunscreen helps prevent new spots and stops treated ones from coming back.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Dermatology: Age spots, how to get rid of them
- American Academy of Dermatology: Melanoma, signs and symptoms (ABCDEs)
- Skin Cancer Foundation: Sun damage and prevention
- MedlinePlus: Aging changes in skin
- Cleveland Clinic: Age Spots (Solar Lentigines)