Dear Doctor: I’m a 60-year-old woman with naturally fair skin. I’ve worked outdoors all of my life — and now I have the age spots on my face to prove it. Why do they happen? Are there any creams that might help to fade them?
A. Age spots are darkened areas that develop on parts of the skin regularly exposed to sunlight. They often appear on the shoulders, backs of the hands, arms, back and face. People who are balding and don’t regularly wear head coverings outside might develop them on their scalps.
Age spots often look like freckles, ranging from light tan to dark brown. Sometimes referred to as sun spots or liver spots, they become more common as we get older but can appear on any part of the skin that has had chronic overexposure to sunlight.
Age spots are your skin’s way to tell you’ve gotten too much sun. They form in response to ultraviolet light, which accelerates pigment production. Unlike cancerous and precancerous growths, which they can resemble, age spots don’t require medical treatment, though some want them removed or lightened.
Treatments include fade creams and lotions that typically use hydroquinone, glycolic acid or kojic acid. Nonprescription versions are available.
More powerful fade creams are available by prescription. These tend to lighten the spots but might not remove them. It can take weeks, even a few months, of consistent use to see improvement.
It’s a good idea with fade creams to get guidance from your health care provider as the active agents can cause side effects.
For more complete results, there’s laser therapy, which destroys specific pigments. Cryotherapy — freezing the skin — and acid peels to exfoliate the skin also sometimes are used. Each can cause side effects such as pain, excessive dryness, blistering, redness and swelling.
It’s crucial to also stop exposing your skin to sunlight. Use a full-spectrum sunscreen, stay in the shade, and cover your skin — with long sleeves, long pants, hats, scarves or gloves. Some of our patients have invested in SPF clothing. Others use an umbrella to block the sun.
Unless you minimize sun exposure, age spots will return, and new ones might form.
Some cancerous and precancerous growths can start out looking like age spots. We recommend all adults regularly monitor moles, marks and birthmarks on their skin for changes in addition to an annual skin-cancer screening by a doctor.
Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.
