Solar Lentigines

Overview

Solar lentigines, commonly called age spots, liver spots, or sun spots, are flat, darkened areas of skin caused by long-term exposure to sunlight. Despite the name "liver spots," they have nothing to do with the liver. They appear most often on areas regularly exposed to the sun, such as the face, backs of the hands, shoulders, upper back, and forearms.

These spots are harmless and very common, especially in older adults and in people who have had a lot of sun exposure over the years. The main reason to recognize them is that other skin changes, including some skin cancers, can look similar, so it is important to know when a spot should be checked by a doctor.

Solar lentigines are essentially a visible record of sun exposure over a lifetime, which is why they cluster on the areas that catch the most sunlight. They do not turn into cancer, but because they appear on the same skin where skin cancers can develop, regular skin checks and attention to any changing spot remain worthwhile.

Symptoms

Solar lentigines are a change in skin color rather than a source of discomfort. Typical features include:

• Flat, well-defined spots that are tan, brown, or dark brown
• Sizes ranging from a freckle to about a centimeter or more
• Location on sun-exposed skin, especially the face and backs of the hands
• Smooth surface with no itching, pain, or scaling
• A tendency to appear in groups and to darken with more sun

Because they are purely a pigment change, any spot that becomes raised, develops uneven or multiple colors, has irregular borders, grows quickly, itches, or bleeds should be examined to rule out skin cancer.

Causes

Solar lentigines form when ultraviolet (UV) light from the sun or tanning beds causes pigment-producing cells in the skin to make extra melanin, which collects in concentrated spots. Years of accumulated sun exposure are the underlying cause, which is why the spots usually become more numerous with age.

They are essentially a sign of cumulative sun damage. People who have spent a lot of time outdoors, used tanning beds, or have fair skin that burns easily tend to develop them earlier and in greater numbers.

Risk Factors

• Older age
• Fair skin that burns rather than tans
• A history of frequent or intense sun exposure or sunburns
• Use of tanning beds
• Living in sunny climates or working outdoors

Diagnosis

Solar lentigines are usually diagnosed by their appearance:

• Skin examination: A doctor or dermatologist can often identify age spots by sight.
• Dermoscopy: A handheld magnifier helps distinguish them from other pigmented spots.
• Skin biopsy: Performed if a spot has worrying features, to rule out skin cancers such as melanoma or to confirm the diagnosis.

Telling a harmless age spot from an early skin cancer can be difficult, so professional assessment is wise for any changing spot.

Treatment

Solar lentigines do not need treatment for health reasons, but they can be lightened or removed for cosmetic purposes. Options include:

• Sun protection: Preventing further darkening and new spots is part of any plan.
• Topical treatments: Prescription creams containing ingredients such as hydroquinone or retinoids can gradually fade the spots.
• Procedures: Laser and intense pulsed light treatments, cryotherapy (freezing), and chemical peels can remove or lighten spots.
• Cosmetics: Makeup can be used to cover spots without any medical treatment.

Treatments should be done or supervised by a qualified professional, and results vary depending on skin type and the depth of pigment. New spots can still form afterward without continued sun protection.

Prevention and Self-Care

• Use broad-spectrum sunscreen daily and reapply regularly when outdoors
• Wear protective clothing, wide-brimmed hats, and sunglasses
• Seek shade during the strongest midday sun and avoid tanning beds
• Check your skin regularly and note any spot that changes
• Have new or changing pigmented spots reviewed by a doctor

When to See a Doctor

See a doctor or dermatologist to have a spot checked if it is new, changing, dark or black, has irregular or blurred borders, contains more than one color, is asymmetrical, grows quickly, itches, or bleeds. These features can indicate skin cancer rather than a harmless age spot.

Solar lentigines themselves are not an emergency, but early evaluation of any suspicious skin change gives the best chance of catching a serious skin condition early.

Related Topics

Frequently Asked Questions

References

1. American Academy of Dermatology. Age spots (solar lentigines).
2. Mayo Clinic. Age spots (liver spots).
3. Skin Cancer Foundation. Skin cancer prevention.
4. MedlinePlus, U.S. National Library of Medicine. Aging changes in skin.