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All About Age Spots

By Ross S. Levy, MD FAAD | Dermatology 

Keep Your Skin Younger Longer

If it looks like a duck, walks like a duck and talks like a duck, then it must be a duck.  When it comes to unsightly skin blemishes, however, this adage does not necessarily apply.  That’s because not all “age spots” are simply “age spots.”  Only an evaluation of the skin by a certified dermatologist can determine the difference between potentially precancerous skin conditions and harmless skin marks that affect our appearance and self-esteem more than our health.

What Causes Age Spots?

Heredity; personal habits, including exposure to the sun; and the environment are the primary factors dictating how the skin ages.  True “age spots,” also called liver spots or solar lentigines, appear as freckles — flat, oval, and brown, tan or black areas of increased pigmentation on the skin.  They occur when skin cells increase the production of pigment as a protective mechanism against the sun’s ultraviolet rays or environmental stresses.  Oftentimes, these skin spots are grouped together, making them more noticeable.  They usually appear on the face, shoulders, upper back, arms and backs of hands – places that receive the most sun exposure. Persons age 50 or older are at increased risk of developing these skin splotches, but they can occur at any age.


Even though age spots pose no health threat, patients oftentimes want to remove them or reduce the number of them for cosmetic reasons.  Makeup will conceal the spots temporarily, but not eliminate them.  Although advances in medication and therapy have improved physicians’ ability to treat aging skin, each approach has its pluses and minuses.

Over-the-counter creams, of course, are not as effective in lightening or eliminating age spots as prescribed medications like hydroquinone, which can penetrate the top layer of skin to slow-down the activity of the pigment-producing cells.  Hydroquinone must sometimes be used in combination with other topical agents, because it can irritate the skin and even stimulate pigmentation if used for too long a period.

Other, more comprehensive treatments to eradicate age spots are available, but usually require multiple sessions.  Among these treatments are:

  • Cryotherapy, in which a freezing agent is applied to the age spot to eliminate the extra pigmentation.
  • Laser therapy, which destroys the offending pigment cells without harming the surface of the skin.

A dermatologist will recommend the best treatment options following an examination of a patient’s skin.

When an Age Spot Is Not an Age Spot

But, not all spots are age spots.  What looks like a pigment splotch may be actinic keratosis (AK), a condition, caused by sun damage, that prompts skin cells to grow abnormally into scaly, discolored patches. These patches may appear brown, tan, gray or even pink. Although not normally dangerous, the lesions can develop into squamous cells carcinoma – a skin cancer – and must, therefore, be monitored carefully by a dermatologist.  Fair-skinned individuals who have had long-term exposure to the sun are most at risk.

Tips to Keep Skin Healthy

All the best treatments in the world, however, are not as effective in eliminating age spots and reducing risk for other aging-skin conditions as prevention.  Skin is the largest organ in our body and the main barrier between us and the environment.  Here are a few simple tips to keep skin healthy:

  • Limit exposure to the sun.  When outdoors, apply a sunscreen with a protection factor of at least 30 or higher to exposed skin and wear a hat. Skin ages prematurely each time a person “gets a tan.”
  • Eat a well-balanced diet and drink less alcohol.
  • Exercise regularly.
  • Cleanse the skin gently.  Scrubbing it can irritate it and speed the aging process.
  • Wash your face twice daily, especially after sweating heavily while working or exercising.
  • Apply a facial moisturizer/ Sunscreen daily!!!
  • Avoid skin-care products or makeup that irritates the skin.

And, if you smoke, stop it! Smoking causes wrinkles and a sallow complexion, in addition to other, more serious health problems.

To schedule an appointment with your Dermatologist, or for more general Dermatology information, click here. For more information on Dr. Levy, click here.