What are age spots?
Age spots are flat tan or brown spots with well-defined borders between 2 millimeters and 30 millimeters in size. Occasionally, they can be slightly scaly or have a rough surface. Age spots are caused by a proliferation of normal melanocytes (the cells that produce melanin) in the epidermis as the result of chronic sun exposure. These lesions are commonly found on the face, especially the forehead and temples, the backs of the forearms and hands, and the shoulders and back. They are less commonly found on the trunk and legs. Age spots have no malignant potential.
No treatment is needed for age spots. Sunscreens and sun protection are usually advised because they help to decrease the rate of appearance and darkening of these lesions. Some older adults may seek treatment for cosmetic reasons. When treatment is sought, liquid nitrogen cryotherapy is usually used to lighten or remove the spots. This therapy is usually effective because melanocytes are more sensitive to cold than epidermal cells are. Trichloracetic acid may also be used to lighten or remove age spots. Bleaching agents such as tretinoin (Retin A) or hydroquinone may lighten age spots slowly, usually over three to four months. The color will return, however, if the use of the bleaching cream is discontinued. Esthetic laser therapy is also becoming another option for treatment. It works by directing a specific wavelength of light that passes through the skin but is absorbed by the discolored area. The rapid absorption of light energy causes the lesion to retract. It is then removed by the body’s natural filter system. The procedure is performed on an outpatient basis and typically without local anesthesia.
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