Age Spots

Lentigines (age spots) and ephelides (freckles) are tan, brown or black spots that appear over time on sun exposed areas of skin. These spots are common on the back of the hand, face and legs. Those who tan extensively will also have them over the shoulders, back, chest and many other areas of skin.

Lentigines are superficial collections of skin pigment called melanin -the pigmented cells in your skin- which have accumulated within the top layer of skin called the epidermis. Ephelides are common in lighter type skin in individuals who sunburn easily. Lentigines usually appear later in life and can occur in all skin types.

Age spots known medically as lentigos are often called "liver spots" or "age spots." Both terms are misnomers. While freckles do tend to appear over time, they are not in themselves a sign of old age. Instead, they appear on sun-exposed areas in people who have a genetic tendency to develop them.

Unprotected skin, on being excessively exposed to UV rays- whether from a tanning booth, a sunlamp or years of going without sunscreen, protects itself by producing an overabundance of melanin - resulting in uneven patches. Age spots or lentigos and seborrhoeic keratoses are brown patches which commonly appear on the back of the hands the face and the back this pigment is deposited as a form of response to injury just like a scar is a response to a cut.

Sun spots are harmless and do not need to be treated unless they are changing or getting bigger than the surrounding sun spots.

Even when this condition is harmless, should not be confused with melanoma, a form of skin cancer. Lentigo's affects both sexes equally. Ethnically, the majority of cases occur in skin types I-II, although Lentigo has been reported in all other types, but on very rare occasion. The lighter complexion in Caucasians increases one's sun sensitivity and gives way for the increased risk of having the condition. Individuals that suffer from the inability to tan to natural sunlight are especially at risk. Genetic factors should also be considered; persons with a family history of melanoma, or potential precursors to melanoma are more at risk to developing lentigos.

Lentigo-type freckles & Seborrheic Keratoses

Sometimes, older people who have these lentigo-type freckles also have raised, brown, crusty lesions called seborrheic keratoses. Seborrheic dermatoses are also benign (not malignant) growths of the skin. Although they are most often brown and they can differ in color and range anywhere from light tan to black. They occur in different sizes, too, ranging anywhere from a fraction of an inch (or centimeter) to an inch (2.5cm) in diameter.

The telltale feature of seborrheic keratoses is their waxy look. They look like they have either been pasted on the skin or may look like a dab of melted brown candle wax that dropped on the skin. Seborrheic keratoses may occur in the same areas as freckles but, since they are not caused by sunlight, they can also be found on covered areas. When they first appear, the growths usually begin one at a time as small rough bumps. Eventually, they thicken and develop a rough, warty surface.

Almost everybody eventually develops at least a few seborrheic keratoses since, like the lentigo-type of freckles; they tend to become more common with age.

Surgical treatment options

Cryotherapy

Until recently the treatment of choice for age spots was cryotherapy. With this technique liquid nitrogen (freezing) is sprayed very gently on the spots to induce a localized frostbite. After two or three weeks the treated age spots peels off as the underlying skin pushes to the surface leaving a residual area of pinkness that might last for only a week but could linger on for months. Scarring may occur.

Laser therapy

The pigment removal lasers act in a similar fashion to a guided missile The light from the laser has a selective affinity for brown discoloration in the skin. It passes harmlessly through the top layer of skin and when it hits the brown pigment cells energy is released causing the melanosomes in the cell to break into minuscule particles which are removed by the body immune system.

The age spot turns grey initially them within minutes forms a superficial brown curst. Within 2 weeks the crusts will be sloughed and the skin underneath will be pink. This gradually fades to the color of the surrounding skin over the course of 2 to 3 weeks. The crust must not be picked or rubbed off otherwise a scar will results.

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Last modified: November 30, 2007