Update: 14. October 2019
Brown spots on the skin that appear increasingly with age: these are in most cases age spots. Frequent exposure to sun and genetic factors can promote their development. In this post, what age spots are exactly and how they can be removed is answered for you by Dr. Hero Schnitzler, Specialist for skin and venereal diseases.
- What are age spots and how do they develop?
Age spots are a benign and therefore harmless pigmentation disorder of the skin. Doctors refer to these spots as senile lentigines, solar lentigines or lentigines simplex. Informally, they are also called liver spots or sun spots.
As the name implies, pigmentation spots increase with age. Dermatologists frequently observe these in people over the age of 40 and for the 60 plus generation, they are considered normal. However, even younger people can get “age spots”.
Lentigines develop primarily on areas of the skin which are often exposed to sun; back of hands, forearms, face and chest. The spots typically appear yellowish-brown to dark brown. They can be miniscule and may grow to be few centimeters in size. Their shape ranges from round, oval to an irregular limited spot. Unlike freckles, age spots rarely fade in winter.
- What is the difference between age spots and other pigment spots?
Age spots are so-called pigmented lesions, that is, cells with hyperpigmentation. These are distinguished from the pigment changes, since these are skin lesions emanating from the pigment-forming cells of the skin, such as moles, known as melanocytic nevi.
But the melanoma skin cancer also originates in the pigment-forming cells. It is therefore extremely important that an experienced doctor, preferably a dermatologist, evaluates each individual patch to determine their cause.
- Can creams reduce age spots?
Yes, there are certain fading creams, these however mostly result in only a slight color reduction. In addition, these creams can have side effects such as irritation and are usually pricey compared with the minimal success.
- Can you prevent age spots?
The predisposition to age spot susceptibility has been placed with us in the cradle by our parents. It is a known proven fact that the more the skin is exposed to the sun during our life, the more likely lentigines will development. Therefore, you should definitely and also to reduce the risk of skin cancer, consequently use sunscreen.
- Can age spots be permanently removed?
Yes, there are various therapies which permanently remove these spots. In addition to the above-mentioned creams, which of course may be successful, freezing with liquid nitrogen and sanding down (dermabrasion) is also used. But, these forms of therapy are rather a thing of the past. Nowadays, laser removal is the number one choice of therapy.
- Which treatments can remove age spots?
Today, doctors generally only use lasers to permanently remove lentigines. With this method, age spots can be easily removed forever. Thereby, the laser pulse penetrates the skin and shatters the concentrated pigments without injuring the uppermost skin. The smaller fragments of pigment can then be naturally expelled by the body. Laser therapy is relatively painless and the use of numbing creams or local anesthetics is not necessary.
- Which laser can remove age spots?
The most suitable lasers are the Q-switched lasers. These have very short yet very intense pulses. Of these lasers, the gold-standard for the removal of lentigines in my opinion, is the Ruby laser. I have had the best experience with this laser as it is the gentlest and most effective laser therapy for age spots. But also, with others such as the Pico-Laser and the neodymium-YAG or KTP lasers, good results can be achieved.
- How often does the laser treatment have to be repeated?
Mostly, one session is enough to remove the spots. Occasionally two or three sessions with at least four week intervals, may be necessary. This is however the exception.
- What do I have to consider before and after a laser treatment?
Immediately after the laser therapy, the treated spots will be slightly discolored and subsequently, a small crust may form. These crusts fall away within a week and with that, the spot also disappears. It is extremely important both before and after such a laser therapy to consequently use sunscreen for at least four to eight weeks.
- Does scarring occur from the removal of age spots?
Theoretically, it is of course possible that scars can form, this however really only in the case of inflammation of the treated spots following treatment. Indeed, the use of the wrong laser or incorrectly chosen laser-parameters can also lead to scarring. It is therefore especially important that treatment is performed by a laser-experienced dermatologist.
Furthermore, the patient should consider that only a dermatologist or experienced doctor can detect malignant skin patches or growths. An age spot may just very well be a lentigo malignant melanoma. These by no means should be lasered, rather they must be surgically removed.
Dr. med. Hero Schnitzler – Expert Tip
Dr. Hero Schnitzler is a specialist in skin and venereal diseases and founder of the “derma competence center” in Zurich Enge. For more than a decade, he has been active in the field of laser medicine and the training of doctors in this field. He also specializes in non-invasive aesthetic therapies.