Everything You Need to Know About Age Spots

Have you noticed a mark that resembles a large freckle on the back of your hand or on your cheek? You may be looking at what’s known as an age spot.

Age spots are flat brown, gray, or black spots on the skin. They usually occur on sun-exposed areas, like the backs of your hands and your face. Age spots are also called liver spots, senile lentigo, solar lentigines, or sun spots.

It’s not uncommon for a single age spot to appear, or for a few to cluster together.

While they may begin developing at an early age, and even during childhood, they’re most common in middle age and older adulthood, especially if you spend a lot of time in the sun.

The good news: Age spots aren’t cancerous, and they don’t develop into cancer, either. That said, it’s always a good idea to ask a dermatologist to evaluate any new spots on your skin.

Here’s what to know about age spots, including why they happen, possible risk factors, and how to remove them.

Age spots typically happen due to an excess production of melanin, or skin pigment. Experts don’t know exactly why age spots develop, but some people do have a hereditary predisposition to them. In other words, you may have a higher chance of age spots if they run in your family.

Other possible causes include skin aging, ultraviolet (UV) light exposure, such as tanning beds, and sun exposure. That’s why you’re most likely to develop age spots on areas of your skin that receive the most sun, such as:

• your face
• the backs of your hands
• your shoulders
• your upper back
• your forearms

While anyone can develop age spots, they tend to show up more commonly in people with certain risk factors. These include:

• being older than 40 years old
• having fair skin
• having a history of frequent sun exposure
• having a history of frequent tanning bed use

The main symptoms that characterize age spots include:

• Color. Age spots range from light brown to black in color. They may darken after time in the sun.
• Texture. The spots have the same texture as the rest of your skin. They typically appear on sun-exposed areas. They’re flat to the touch and don’t cause any pain.
• Size. Age spots can vary from the size of a very small freckle to an inch in diameter.
• Grouping. They may appear on their own or in a group, which can make them more noticeable.
• Shape. Age spots are typically round or oval, with very defined edges.

A dermatologist or healthcare professional will usually diagnose age spots with a visual inspection, a biopsy, or both.

Visual inspection

During a visual inspection, your doctor will assess the color, size, and shape to determine whether your mark really is an age spot.

They might also feel the spot to determine whether it has a raised texture or the same texture as your surrounding skin.

Biopsy

If your doctor or dermatologists believes the dark area may be something other than an age spot, they’ll typically suggest a biopsy.

This procedure involves removing a small piece of skin from the age spot and sending it to a lab to test for cancer or other abnormalities.

Age spots don’t cause any health problems, so treatment typically isn’t necessary. That said, you might want to remove age spots because of their appearance.

Options for treatment include the following.

Prescription medications

A dermatologist may prescribe bleaching creams to help fade the age spots gradually. These creams usually contain hydroquinone and sometimes retinoids, such as tretinoin.

Just keep in mind that these creams usually take several months to fade age spots.

Also note that bleaching and tretinoin creams can leave your skin more sensitive to UV damage. It’s essential to wear sunscreen at all times, both during treatment and afterward — even on cloudy and overcast days.

Medical procedures

A number of medical procedures can remove or reduce age spots, but these procedures do carry some risk of side effects and complications.

Ask your dermatologist, plastic surgeon, or other skin care professional about which treatment may be most effective for your skin.

Medical procedures for age spots include:

• Intense pulsed light (IPL) treatment. This treatment emits light waves that pass through the skin and target melanin to destroy or break up age spots. You might experience some redness or swelling after the treatment, but you can return to your regular activities right away. Other potential side effects include bruising, blistering, skin color changes, or infection.
• Chemical peels. These remove the outer layer of your skin, so new skin can grow in its place. Common side effects include redness, dryness, stinging or burning, and mild swelling. More serious side effects, which could be permanent, include scarring, lightning or darkening of the skin, or infection. Deep chemical peels can, in some cases, damage your heart muscle, liver, or kidneys. Recovery times after a chemical peel may take between 4 days and 2 weeks, though redness can remain for several months.
• Dermabrasion. This procedure sands away the outer layers of the skin, so new skin can grow in its place. After this procedure, your skin will likely appear pink and swollen, with a burning or tingling sensation. It can take about 3 months for skin to fully heal. Side effects include acne flares, temporary or permanent skin color changes, scarring, or enlarged pores.
• Cryosurgery. This procedure freezes individual age spots with liquid nitrogen. After the procedure, you may notice blisters, pain, and swelling. Other possible side effects include darkening of the spot, lightening of the skin around the age spot, or scarring.
• Laser treatment. This treatment uses specific wavelengths of light to remove the spot. Side effects include temporary darkening of the spot. After treatment, you’ll need to keep the area clean and avoid picking any scabs.
• Microdermabrasion. This procedure smooths away the outer layer of skin. It involves little to no recovery time, but you’ll want to stay hydrated and keep your skin moisturized afterward. Potential side effects can include tenderness, swelling, and redness.

While it’s important to wear sunscreen every day, it’s essential to wear sunscreen after any skin treatments or procedures. Sunscreen protects your healing skin from UV damage, but it also helps prevent age spots from returning.

Over-the-counter treatments

You can also find plenty of over-the-counter (OTC) creams marketed as treatments for age spots. These creams aren’t as strong as prescription creams, but they could help remove excess skin pigmentation.

In short, it’s generally OK to try them before making an appointment with a dermatologist, but keep in mind that they might not be as effective as professional treatment.

If you want to use an OTC cream, opt for one that contains one of the following ingredients:

• deoxyarbutin
• glycolic acid
• alpha hydroxy acid
• kojic acid

Cosmetics don’t remove age spots, but they can certainly help cover them. Ask your dermatologist, plastic surgeon, or a makeup expert about brands and products that effectively conceal age spots.

Other kinds of spots that may appear on your skin as you age include seborrheic keratoses, actinic keratoses, and skin cancer.

Seborrheic keratoses

This round or oval skin growth can appear anywhere on the body except the soles of your feet, the palms of your hands, and near your mucous membranes.

These growths:

• tend to begin as small and rough areas before developing a thick, wart-like appearance
• can appear waxy with a slightly raised surface
• are often brown, but can be yellow, white, or black

Seborrheic keratoses aren’t harmful, but sometimes they can be hard to distinguish from melanoma.

Actinic keratoses

Actinic keratoses typically:

• appear as rough, scaly spots on the hands, arms, or face
• show up in patches about the size of a pencil eraser
• appear in areas that have extensive years of sun damage

You’re more likely to develop actinic keratoses if you:

• are over the age of 60
• have light-colored hair and blue eyes
• burn easily in the sun
• have had lots of sun exposure over your lifetime.

While this kind of spot isn’t a form of cancer, it can progress to squamous cell carcinoma. That’s why it’s important to have these spots examined by a doctor or dermatologist.

Skin cancer

Skin cancer often appears on the face, chest, arms, and hands. It usually appears as a new or unusual mole, freckle, or spot. However, symptoms and appearance of the spot can vary, depending on the type of skin cancer.

If you notice any changes in skin spots or moles, it’s always best to have them checked by a doctor.

While age spots don’t require medical treatment, a few key signs can suggest it’s time to schedule an appointment with your doctor or dermatologist.

If the appearance, shape, or size of your age spots change over time, you’ll want to have those checked out. You’ll also want to ask a healthcare professional about any spots that:

• have an unusual combination of colors
• appear black
• have irregular borders or edges
• bleed

While you can’t always prevent age spots, you can take a few steps to help lower your chances of developing them:

• Avoid the sun between 10 a.m. and 4 p.m., when the sun’s rays are most intense.
• Wear sunscreen every day. It should have a sun protection factor (SPF) rating of at least 30 and contain both UVA and UVB protection.
• Apply sunscreen at least 30 minutes before sun exposure. Reapply every 2 hours, and more often if swimming or perspiring.
• Wear protective clothing, such as hats, pants, and long-sleeved shirts. These help protect your skin from UV rays. For the best protection, wear UV-blocking clothes with an ultraviolet protection factor (UPF) of at least 40.

Age spots are harmless changes to the skin that don’t cause pain. In some cases, though, their appearance could cause some emotional distress, or even concerns about skin cancer.

If you’ve noticed any changes in your age spots or would like to try having them lightened or removed, a healthcare professional or dermatologist can examine the spots and offer more guidance about your options for treatment.