Age spots

Age spots - also called solar lentigines or liver spots - are flat brown or black spots that appear on sun-exposed skin: the face, backs of the hands, forearms, shoulders and upper chest.

The name is misleading. Age spots are not a marker of how old you are. They are the record of cumulative sun exposure. They generally start appearing after 40 because that is how long the damage takes to show, but younger people with heavy sun exposure get them too.

Have them examined before treating them

This matters more with age spots than with almost any other pigmentation, because the things they can be confused with are the things you least want to miss:

Seborrhoeic keratosis - benign, but raised and waxy rather than flat
Pigmented basal cell carcinoma - a skin cancer that can present as a pigmented patch
Lentigo maligna - an early melanoma that typically appears as a slowly enlarging flat brown patch on chronically sun-damaged skin, most often on the face of an older person. It looks very like an age spot.

A lesion that has not been examined should not be lasered, frozen or burned off. Those methods destroy the tissue, so if it was a cancer there is nothing left to send to pathology and no record that it existed. Anything with features of concern is excised whole and tested instead. See skin cancer and mole removal.

Have any dark spot checked if it is new, growing, changing colour, irregular in outline, itching, bleeding or not healing.

Treatments used for age spots

Laser and light - Nd:YAG, erbium, Fraxel, CO2, IPL and Laser Genesis, chosen by skin type and lesion depth
Photodynamic therapy, for field treatment of sun-damaged skin
Cryotherapy - for individual assessed lesions
Chemical peels
Cosmeceutical skincare, including vitamin A derivatives and antioxidants
Microdermabrasion
Skin needling
Mineral make-up - cover plus physical sun protection

Each of these has its own benefits and risks, and what suits you depends on your skin type, the number and depth of the spots, and your tolerance for downtime. Some topical agents are prescription-only.

What results are realistic

Individual age spots often lighten considerably, and some clear. Treating them does not stop new ones forming - the underlying sun damage is already in the skin, and further exposure adds to it.

Most people need more than one session, and hands in particular tend to respond more slowly than the face. Sun protection is what keeps the result. Individual results vary.

Risks

Redness, swelling and crusting after treatment
Blistering
Hypo-pigmentation - a pale patch where the spot was, which can be permanent and conspicuous on sun-damaged skin
Post-inflammatory hyper-pigmentation, more likely in darker skin types
Scarring
Infection
Incomplete clearing and recurrence
Increased sun sensitivity after treatment
Missed diagnosis where a pigmented lesion is destroyed rather than examined

See risks and complications.

Cost

As at September 2024 and including GST, a skin assessment is $50 and a Cosmetic Doctor consultation is $150. Dermal skin treatments start from $130. Cosmetic treatment is not covered by Medicare; medically indicated treatment may attract a rebate.

Booking

Me Clinic, 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511, or use the online consultation form.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.