Liver Spots (Solar Lentiginosis)

Written by Mary Ellen Ellis
Medically Reviewed by George Krucik, MD

What Is Solar Lentiginosis?

Solar lentiginosis is a very common dermatological condition that occurs mostly in white people over the age of 40. The condition involves the appearance of pale brown to dark brown spots on the skin called solar lentigines, liver spots, or age spots. Age spots are flat, usually oval areas of the skin that have increased pigmentation. In other words, they are darker than the surrounding skin. They may be brown, black, or gray in color.

They are most common on parts of the body that are exposed to the sun regularly. This includes the face, hands, arms, tops of the feet, shoulders, and your upper back.

Although they can sometimes look like cancerous growths, age spots are harmless. However, treatments such as skin lightening or removal can be used for cosmetic purposes. The best prevention for developing age spots is avoiding the sun and wearing sunscreen.

What Causes Solar Lentiginosis?

Ultraviolet (UV) light from the sun is the primary cause of age spots. The pigment that gives your skin color is called melanin. UV light speeds up the production of melanin, which results in the darker skin of a tan. After years of exposure to UV light, melanin gets clumped in certain areas and is produced in high concentrations. This results in age spots.

You can also be exposed to UV light in tanning beds. An artificial source of UV light is no different from the natural light of the sun. The process of aging, regardless of UV exposure, also increases production of melanin and leads to age spots.

Some people may be more susceptible to the formation of age spots because of their genetic makeup. For example, individuals with fair skin and blond hair may be more likely to develop lentigenes.

Conditions That Resemble Solar Lentiginosis

Solar lentigenes are harmless. Some skin conditions that may resemble lentigenes may be more serious. These include moles, melanoma (malignant skin cancer), keratosis (noncancerous skin growth), and lentigo maligna (a type of skin cancer).

See your doctor if you notice the following characteristics in your skin spots:

  • very dark pigmentation
  • an increase in size over a short period of time
  • an irregular border
  • itching, tenderness, bleeding, or redness
  • a combination of colors

Diagnosing Solar Lentiginosis

Your dermatologist will begin with a visual inspection to diagnose solar lentigninosis and to rule out any other skin conditions. Dermatologists can usually identify age spots simply by looking at them.

If you or your doctor have any concerns or believe that there is a possibility your age spot is something else, you may need a skin biopsy. This means that your doctor will take a small sample of skin from the area in question. You will receive a local anesthetic and the doctor will cut away a small piece of skin. The sample will be sent to a lab for examination. By examining the skin cells, a laboratory tech can determine if you have a condition other than solar lentiginosis.

Treatment for Solar Lentiginosis

Because age spots are harmless, there is no need to receive any treatment. However, many people choose to treat age spots for cosmetic reasons. Topical medications are often less effective than physical procedures, but the latter can produce unwanted side effects.

Medications

Your dermatologist can prescribe bleaching creams to lighten age spots. These are often used in conjunction with steroid and retinoid creams. Together, these medications can lighten your skin over time.

Cryotherapy

Cryotherapy involves using liquid nitrogen to freeze the skin of the age spot. This can destroy the melanin that is producing the dark color. There is a small risk of scarring with cryotherapy.

Dermabrasion

Dermabrasion involves using a rotating brush to scour your skin and remove its surface layers. You may experience redness and scabbing from this procedure.

Laser Treatments

Using a laser on age spots can destroy the cells that are producing melanin. This treatment requires several visits and will cause the age spots to fade over the course of several weeks or months. There are no side effects if laser therapy is done correctly. This is the most costly removal technique.

Chemical Peel

Acid is applied to the skin to dissolve its outer layers. New skin forms where the layers were destroyed. The treatment must be done several times to see results. Irritation is mild to severe. Protecting your skin from the sun immediately after the treatment is highly recommended.

Preventing Solar Lentiginosis

The best way to prevent the formation of age spots is to avoid exposure to the sun and tanning beds. Use sunscreen that provides protection from both types of ultraviolet light: UVA and UVB. Cover yourself with a hat, sunglasses, and clothing when out in the sun.

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