In the eternal battle to ward off the visible signs of aging, the battle to prevent age spots is one worth fighting.
You know the enemy. Age spots (also called “liver spots”) appear as medium to large, flat freckle-type growths that appear on the hands, face and arms. They typically occur after age 40 in fair skinned people who have spent time in the sun.
What causes age spots?
In a word: SUN! Age spots develop in areas of sun exposure after many years in the sun. The usual age of onset is 40-50. Some patients may have a hereditary predisposition. The name “liver spots” is a misnomer. They are not due to liver disease. The medical name is lentigo or lentigines.
Some patients over 40 develop tan or dark brown warty growths called seborrheic keratosis. These are another type of age spots. Topical treatments used for lentigos do not work for keratoses since the latter are thicker.
What treatments are available for age spots?
The first step is to begin a prescription strength home program. Typically dermatologists prescribe a combination of hydroquinone, a skin brightener with tretinoin, a prescription strength exfoliator. Since this combination may be irritating, a low potency topical steroid is often added in. Triluma and other brands such as our HQRA+ combine the three medications into one product. This “triple bleaching cream” is used at night with another skin brightener in the am. Other ingredients that reduce pigmentation include topical vitamin C and kojic acid.
Fanatic sun protection is key during treatment and to prevent recurrence.
- Wear SPF daily. I recommend#30 SPF or more. And remember to reapply if you are outdoors more than 90 minutes. Protect yourself – face, arms and hands while you are driving.
- Wear a hat and cover up: Sun protective clothing in the form of long sleeve shirts, sun sleeves and wide brimmed hats really works. In fact, clothing blocks the sun better than sunscreen.
- Avoid midday sun: If you can schedule activities earlier in the day or after 4, you will be protected from midday intense sun.
Laser Treatments for age spots
If three months of topical therapy does not resolve the problem, do not despair. There are several types of lasers that work for brown spots.
For overall skin resurfacing which treats both wrinkles and brown spots, I recommend the Fraxel Erbium laser or the Fractionated CO2 laser. The Fraxel laser is safer for the face and arms. It does require a series of 4 treatments for optimal results.
If just a few spots need treatment, the VBeam pulsed dye laser is effective. A second treatment may be needed after 3 or 4 weeks, if the lesion does not resolve. Other laser options include the Yag laser and the Pico laser. The latter is also used for tattoo removal
Freezing or Cautery for age spots or brown spots
If the lesions are thick or raised above the skin, laser treatment may not be effective. The raised lesions are another type of age related growth called seborrheic keratosis. These growths are often treated with cryosurgery or freezing. Electrocautery, which destroys growths with heat is another option. Cautery is an optimal choice for removal of seborrheic keratosis in darker skinned patients as there is less chance of pigmentary alteration.
A few tips about age spots.
Keep in mind that treatment of age related spots is considered cosmetic and is typically not covered under your health plan. Fees for removal of a few up to 15 spots may run up to several hundred dollars
Can age spots be dangerous?
Usually not, although It is important to see a dermatologist for evaluation, as some lesions you are calling age spots may actually be precancerous. If you are concerned about age spots , contact our Torrance office for a skin exam.