Believe it or not, freckles are the first sign of aging. When you're young, these summer-induced spots gradually fade in the winter months, serving in the meantime as a reminder that protection against ultraviolet (UV) rays is a daily must.

With age, however, the spots that used to come and go with the seasons begin to take up permanent residence on sun-exposed skin. You may think of these simply as unavoidable age spots on skin, but there is much more to the story. In this case, they are called lentigines.

Lentigo Lingo

A lentigo, or lentigines (len-TIJ-uh-neez) in the plural, is a brown skin lesion with a well-defined border that occurs most commonly on sun-exposed areas, such as the face, hands, upper back, and chest. They are benign, or non-cancerous, in nature but often bring people into the Dermatologist for evaluation and treatment.

Lentigines, are often erroneously referred to as "age spots" or "liver spots." They do indeed come out later in life, but not because of age and not because of liver abnormalities. The sun is the culprit here. If you don't want to use the scientific terminology, "sunspots" is really a more accurate name. Simply put, lentigines affect skin exposed to UV light without enough protection. They can result from one bad sunburn or after years of time outdoors. Under the microscope, one would see an increase in the pigment called melanin within a sunspot's cells. That translates into discoloration and an uneven complexion.

Aim for Prevention

Although they are not cancerous, lentigines are often a cosmetic concern. Luckily, there are many treatment options available. As the saying goes, though, "an ounce of prevention is worth a pound of cure." When it comes to lentigines, prevention is most definitely a possibility. Unlike other genetic skin lesions that will unavoidably occur as we age, lentigines can be avoided altogether with ample sun protection. For optimal defense against UV light, the American Academy of Dermatology recommends the following:

  1. Using a broad-spectrum sunscreen with an SPF of 30 or higher daily, regardless of weather conditions and skin type.
  2. Reapplying every two hours when outside (a nickel size on the face and a golf ball size—about 1oz—over the entire body).
  3. Seeking shade when possible.
  4. Wearing protective clothing, a broad-brimmed hat, and sunglasses.
  5. Avoiding peak sunlight exposure between the hours of 10 a.m. and 4 p.m. when possible.

Following these guidelines strictly can very much limit the amount of damage that the skin incurs, thereby reducing not only discoloration but wrinkling and, most importantly, skin cancer.

According to the Skin Cancer Foundation, 90 percent of the visible signs of aging come from daily, unprotected UV exposure. So, for those worried about developing age spots on skin, remember that these marks can be avoided with proper sun care.

Creams for a Cure

But, if the sunspots prevail despite one's best efforts, there are many treatment options.

Daily sunscreen use is a must. Without this step, it would be nearly impossible to clear lentigines. The ideal formulation is still a broad-spectrum SPF of 30 or higher. Beyond that, incorporating a topical antioxidant and retinoid into a skin routine may aid in both prevention and cure. Adding an over-the-counter or prescription-strength fading cream can also offer additional help in evening out skin tone. Before starting any such skin regimen, however, it's best to speak with your Dermatologist.

Cosmetic Procedures for a Cure

The best, most sustainable outcomes usually result from a combination of product and procedure. This means complimenting a daily skin routine with an in-office treatment can reduce the likelihood that lentigines will make a comeback. Chemical peels are a good place to start when looking into ways to reduce photodamage. Light-based procedures, such as lasers or intense pulse light devices, can also treat larger surface areas, such as the chest and back. The therapeutic path your Dermatologist chooses will most likely depend on the number or location of lentigines.

Trust the Pros

Most importantly, if there is ever a concern regarding the nature of a lesion, make sure to visit a board-certified Dermatologist so that they may examine the spot and direct you to a treatment plan. Do not forget that yearly skin cancer screenings are recommended for anyone 40 years old and older or anyone with a personal or family history of abnormal lesions.

Healthy skin is beautiful skin, so protect it and be on the lookout for any new spots or marks!

Author

  • Dr. Mona Gohara is a Connecticut-based Dermatologist and associate professor of Dermatology at Yale School of Medicine. She has a particular interest in skin cancer prevention and treatment for skin of color. Dr. Gohara spends a lot of time outdoors with her husband, son, and two dogs, Coco and Cleo. They all wear sunscreen.