As you get older, you might notice brown or black spots appear on your skin. These spots are especially common on sun-exposed areas like your face and the backs of your hands. They’re called lentigines, or liver spots. It’s called lentigo because the spots can resemble lentils in color.
A lentigo can grow very slowly over many years, or it can appear suddenly. Multiple spots are called lentigines.
There are a few different types of lentigines. These types are based on the cause and where they appear on your body:
- Lentigo simplex is the most common type. The spots appear on your trunk, arms, and legs. Lentigo simplex often starts at birth or during childhood. The spots can go away in time.
- Solar lentigo is caused by exposure to ultraviolet radiation from the sun. This type is common in people over age 40, but younger people can get it, too. It happens when UV radiation causes pigmented cells called melanocytes in the skin to multiply. Solar lentigo appears on sun-exposed areas of the body, like the face, hands, shoulders, and arms. The spots may grow over time. Solar lentigines are sometimes called liver spots or age spots.
- Ink spot lentigo appears after a sunburn in people who have lighter-pigmented skin.
- PUVA lentigo starts after psoralen and ultraviolet A (PUVA) therapy, which is used to treat conditions like eczema and psoriasis.
- Tanning bed lentigo appears after exposure to an indoor tanning bed.
- Radiation lentigo happens in areas of the skin that have been exposed to radiation — for example, from cancer treatment.
Several inherited syndromes can also cause lentigo, including:
- Bannayan-Riley-Ruvalcaba syndrome: This condition causes a larger-than-normal head, noncancerous tumors, and dark spots on the body.
- Cowden syndrome: This disorder causes many noncancerous growths called hamartomas to form on the body.
- Noonan syndrome: This condition causes lentigines to form on many different parts of the body.
- Peutz-Jeghers syndrome: This condition causes noncancerous growths to form in the stomach and intestines. Children with Peutz-Jeghers often get small dark spots on their faces.
- Xeroderma pigmentosum: This syndrome makes people extra sensitive to UV rays from sunlight.
Lentigo causes flat spots to appear on the body. These spots are usually tan, brown, or black in color. They may have rounded or uneven edges.
Lentigines can appear on different areas of your body, depending on their cause. They don’t itch or cause other symptoms.
What are the causes?
Exposure to UV radiation can cause lentigo. You’re more likely to get this condition if you:
- have fair skin
- have been exposed to the sun a lot, or have had several sunburns
- tan indoors
- have had phototherapy or radiation therapy
In other cases, an inherited syndrome can cause lentigines.
People of all ages and both genders can get lentigines.
How is it diagnosed?
Although lentigines are usually harmless, they’re worth getting checked out by a dermatologist to make sure you don’t have skin cancer. Sometimes a lentigo and the skin cancer melanoma are hard to tell apart.
The doctor will start by examining the spots on your skin. To make sure the spots aren’t skin cancer, you might have a biopsy. During this test, the doctor will numb the affected area of skin and then remove a small piece of the spot. The tissue will go to a lab to be checked for cancer and other skin conditions.
Lentigines are not typically a cause of medical concern, so they don’t need to be treated. However, some may choose to lighten or remove lentigines for aesthetic reasons.
To lighten or remove lentigines, your dermatologist might recommend one of these treatments:
- medicines such as bleaching creams containing hydroquinone or retinoids (tretinoin)
- chemical peels
- laser or intense pulse light therapy to destroy melanocytes
- freezing (cryotherapy) to destroy melanocytes
To prevent lentigo, try to avoid sun exposure, especially during the peak sun hours between 10 a.m. and 2 p.m. When you do go outside in the sun, always wear sunscreen with UVA/UVB protection. Also, put on sun-protective clothing and a wide-brimmed hat.
Lentigo is usually harmless. The spots are noncancerous. Over time, though, you can develop new spots — especially if your skin is exposed to the sun.
In some people, lentigo is related to other health conditions. How severe the lentigo is in these cases depends on the condition that’s causing the spots.