By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

“AGE SPOTS” CAN BE TREATED WITH CREAMS OR HIGH-TECH LASERS

Question: I’m in my early 60s and have noticed the development of small brown spots on the top of my hands and also on my face. I remember that my parents had the same kind of thing when they got older. They called them “age spots.” A friend of mine said they were “liver spots” and had to be removed from the liver first before they would come off the skin. Is this true?

Answer: What your parents called an “age spot” and your friend calls a “liver spot” is referred to as a lentigo by physicians. This is, in part, because we prefer fancy terms and also because it avoids confusion. For instance, the term “liver spot” is very misleading. These blemishes -- or lesions as doctors prefer to call them -- are purely a skin condition and have nothing at all to do with the liver. I assume the name is derived from the fact that these lesions are about the same color as raw liver.

Lentigines –- the plural of lentigo, for those of you needing to brush up on your Latin -- primarily affect Caucasians, although they are not unknown in people of other races. These spots feature a dark area of pigmentation that is not raised or scaly, as occurs in other skin conditions. The lesion differs from a common freckle in that the “liver spot” develops later in life and is generally larger. Freckles also fade after decreased sun exposure, such as over the winter, while “liver spots” do not.

Skin damage from sun exposure is the cause of lentigines. Therefore, as you would expect, they are most common on the back of the hands, the lower portion of the arms and on the face.

It is generally not necessary to treat lentigines, except for cosmetic reasons, since they do not usually develop cancer within them. However, other cancerous and non-cancerous lesions that also occur on sun-damaged skin can be confused with them. Therefore, I’d advise that you bring your “liver spots” to your doctor’s attention to be sure they aren’t something more sinister. If they are simply lentigines, then there are two treatments that can improve the appearance of your skin, which you may want to consider.

Lentigines can be lightened in color by the regular application of hydroquinone. This medication is sold as a non-prescription drug under several brand names. It works relatively well if it is rubbed into the lesion twice each day for about one month. There is also a new prescription product on the market called Solagé that’s effective for some people.

Lasers can be used to treat lentigines quite effectively. One or two treatments typically make the lesion vanish. It takes considerable expertise to wield these “high-tech” tools of medicine effectively, so you will need to see a dermatologist or plastic surgeon if you choose this type of treatment.

It’s important to keep in mind, however, that regardless of the treatment you choose, exposure to sunlight can bring the dark coloration back. So it is important to use sunscreen products with an SPF of 30 or higher when sun exposure is unavoidable.


Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.