Age Spots FAQ


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What are age spots?

Also referred to as sun spots and liver spots, age spots are harmless brown flat spots that are commonly found on sun-exposed skin. They usually don’t appear until middle-age and occur in nearly all skin types. Age spots are collections of a pigment (melanin) that have accumulated in the top layer of the skin (the epidermis). Unlike freckles, which darken in the summer and fade in the winter, age spots do not fade.

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What causes age spots?

Age spots form with age and also with increased sun exposure and are more common in people who freckle and burn easily. It is important to know that if you've had enough sun to develop age spots, you have a higher risk of developing skin cancer.

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Are there any symptoms of age spots?

Age spots have no associated symptoms however, if any of your age spots are changing or becoming larger, you may need further evaluation by your physician to rule out the risk of pre-cancerous or cancerous lesions.

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What do age spots, sun spots and liver spots look like?

Age spots are flat and vary in size from a small pea to a dime. They are usually somewhat rounded and have irregular borders. They are found on chronically sun-exposed areas such as the shoulders, upper back, face, forearms, and the back of hands.

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How are age spots diagnosed?

Your physician can usually diagnose age spots based on their appearance although it is very important to distinguish age spots from melanoma (a form of skin cancer) which can look similar. Let your doctor know if a particular age spot is growing or changing. Sometimes, your physician may need to perform a biopsy to rule out skin cancer.

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What treatment options are available for spot removal?

The best treatment for age spots is prevention which includes avoiding the sun whenever possible and daily sunscreen use. For example, you won’t find age spots on your inner thigh because of minimal or no sun exposure. However, for most of us, it is too late for prevention and there are a number of treatment options available. Treatment options include FotoFacial/IPL treatments, laser resurfacing, bleaching creams and chemical peels.

Bleaching Creams
  • What are they?
  • Over-the-counter creams contain 2 percent hydroquinone which is a bleaching agent. Prescription creams may use single agents, such as Retin-A (tretinoin) or combinations of medications such as hydroquinone with tretinoin plus a cortisone cream.

  • What are the risks?
  • Over the counter bleaching creams are usually well tolerated and may gradually lighten age spots over a couple of months however, they are not very effective. Prescription formulations are often more effective but may have more side effects (such as redness, drying, and peeling) and are expensive. Creams may not work for everyone and the risks and benefits need to be discussed with your physician.

Chemical Peels
  • What are they?
  • Your physician can administer a peel using a variety of different chemicals to remove age spots, discoloration, wrinkles and fine lines. Chemical peels may gradually smooth and firm the skin and lighten age spots. The superficial peels, such as a glycolic acid peel, can be performed during your lunch hour and there is no recovery time. Deeper peels are more effective but require longer recovery. See more details under discussion chemical peels.

  • What are the risks?
  • Different kinds of peels carry different risks. Superficial peels are usually quite safe however, you may need a series of superficial peels (done approximately once a month) before you'll notice any improvement. Costs can add up if you choose a series of peels. The risks and benefits vary depending on the kind of peel needed so discuss them in detail with your physician.

Intense Pulsed Light Therapy (IPL)
  • What is it?
  • IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use intense, focused light, IPL is intense broadband light. Although IPL delivers energy to both the superficial and deep layers of the skin, the epidermis is spared from damage requiring virtually no recovery time. In the studies performed so far, IPL can smooth the skin and fade age spots, freckles, melasma, and even broken blood vessels and with good sun protection, improvements usually last for about a year.

  • What are the risks?
  • Because IPL does not damage the outer portion of the skin (epidermis), it is safer than laser therapy. There may be some pain during the procedure but no recovery time. Unlike laser therapy, however, you may need multiple treatments (average is 4-6 at three weeks intervals) to achieve the full benefit. The cost is variable, but is usually more expensive than peels and less expensive than lasers. As with any surgical procedure, the risks and benefits of IPL therapy need to be discussed in detail with your physician.

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