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Also referred to as
sun spots and
liver spots, age spots are harmless brown flat spots that
are commonly found on sun-exposed skin. They usually don’t appear until middle-age and occur
in nearly all skin types. Age spots are collections of a pigment (melanin) that have
accumulated in the top layer of the skin (the epidermis). Unlike freckles, which darken in
the summer and fade in the winter, age spots do not fade.
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Age spots form with age and also with increased sun exposure and are more common in people
who freckle and burn easily. It is important to know that if you've had enough sun to develop
age spots, you have a higher risk of developing skin cancer.
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Age spots have no associated symptoms however, if any of your age spots are changing or
becoming larger, you may need further evaluation by your physician to rule out the risk of
pre-cancerous or cancerous lesions.
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Age spots are flat and vary in size from a small pea to a dime. They are usually somewhat
rounded and have irregular borders. They are found on chronically sun-exposed areas such as
the shoulders, upper back, face, forearms, and the back of hands.
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Your physician can usually diagnose age spots based on their appearance although it is very
important to distinguish age spots from melanoma (a form of skin cancer) which can look
similar. Let your doctor know if a particular age spot is growing or changing.
Sometimes, your physician may need to perform a biopsy to rule out skin cancer.
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The best treatment for age spots is prevention which includes avoiding the sun whenever
possible and daily sunscreen use. For example, you won’t find age spots on your inner thigh
because of minimal or no sun exposure. However, for most of us, it is too late for prevention
and there are a number of treatment options available. Treatment options include FotoFacial/IPL treatments,
laser resurfacing, bleaching creams and chemical peels.
Bleaching Creams
- What are they?
Over-the-counter creams contain 2 percent hydroquinone which is a bleaching agent.
Prescription creams may use single agents, such as Retin-A (tretinoin) or combinations of
medications such as hydroquinone with tretinoin plus a cortisone cream.
- What are the risks?
Over the counter bleaching creams are usually well tolerated and may gradually lighten age
spots over a couple of months however, they are not very effective. Prescription formulations
are often more effective but may have more side effects (such as redness, drying, and peeling)
and are expensive. Creams may not work for everyone and the risks and benefits need to be
discussed with your physician.
Chemical Peels
- What are they?
Your physician can administer a peel using a variety of different chemicals to remove age
spots, discoloration, wrinkles and fine lines. Chemical peels may gradually smooth and firm the
skin and lighten age spots. The superficial peels, such as a glycolic acid peel,
can be performed during your lunch hour and there is no recovery time.
Deeper peels are more effective but require longer recovery. See more details under discussion
chemical peels.
- What are the risks?
Different kinds of peels carry different risks. Superficial peels are usually quite safe
however, you may need a series of superficial peels (done approximately once a month) before
you'll notice any improvement. Costs can add up if you choose a series of peels. The risks and
benefits vary depending on the kind of peel needed so discuss them in detail with your physician.
Intense Pulsed Light Therapy (IPL)
- What is it?
IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use intense,
focused light, IPL is intense broadband light. Although IPL delivers energy to both the
superficial and deep layers of the skin, the epidermis is spared from damage requiring
virtually no recovery time. In the studies performed so far, IPL can smooth the skin and fade
age spots, freckles, melasma, and even broken blood vessels and with good sun protection,
improvements usually last for about a year.
- What are the risks?
Because IPL does not damage the outer portion of the skin (epidermis), it is safer than
laser therapy. There may be some pain during the procedure but no recovery time.
Unlike laser therapy, however, you may need multiple treatments (average is 4-6 at three weeks
intervals) to achieve the full benefit. The cost is variable, but is usually more expensive
than peels and less expensive than lasers. As with any surgical procedure, the risks and
benefits of IPL therapy need to be discussed in detail with your physician.
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Cosmetic/Plastic Surgery
