Age Spots (Liver Spots): Causes, Symptoms, Diagnosis, and Treatment

Age spots are also called liver spots or sunspots. These are the type of skin pigmentation spots that occurs after the age of 50yrs, but can also occur early if the person spends too much time in the sun. Age spots affect the normal skin and disturbance the normal tone of the skin. These are usually darker than the normal skin color. These can appear as light brown, tan, or black in color. These can be of various shapes, sizes, and colors.

Age spots occur mainly because of the production of melanin in excess amounts. Melanin is the pigment that is responsible for the color of skin and hair. Hence when it is produced in excess amounts it causes the darkening of the skin. Other causes include longer exposure to the sun, ultraviolet rays, and aging. Ultraviolet rays act by increasing the production of melanin. Increased age also causes the release of increased melanin. More exposure to sunlight over the period of several years is directly proportional to the risk of getting age spots.

Age spots are not cancerous but some of the precancerous lesions of the skin such as actinic keratosis can present along with age spots the lesions of actinic keratosis also occur because of high sun exposure and are also seen mainly in the sun-exposed areas

There are various methods available to treat age spots. Treatment of the age spots includes pharmacological therapy such as hydroquinone creams, retinoids, laser therapy, cryotherapy, dermabrasion, and by chemical peeling.

Age Spots: Causes

When the cells age, there is the deposition of the lipofuscin which presents as a flat spot. The aged cell also affects the neighboring cell and alters the repair mechanism and increases the damage. An elevated or raised spot is formed when the cell with accumulated lipofuscin dies it releases the lipofuscin bodies.

The important causes of getting age spots include the following −

• Production of melanin in excess amount

• Exposure to the ultraviolet rays of the sun: Ultraviolet rays act by increasing the production of the amount of melanin which when produced in excess increase the pigmentation of the skin

• Tanning beds

Age Spots: Symptoms

The age spots can be seen more prominently present in people having fairer skin compared to people having darker skin. Age spots present as −

• Can be flat irregular or oval-shaped areas of increased pigmentation

• These are usually darker, brown, gray, or black in color

• These are more commonly seen in the areas of sun exposure such as the back of the hands, and exposed areas of the feet, face, neck, shoulders, and upper back.

• These can be present as a cluster of spots together or as single spots dispersed over more area

Age Spots: Risk Factors

The important risk factors for the development of age spots include −

• Exposure to the sun − larger the amount and the duration of exposure to the sun larger the risk of getting age spots

• Age − Age more than 50yrs are at higher risk

• Tanning beds

Age Spots: Diagnosis

The diagnosis is done based on the clinical presentation. No laboratory investigations are required to diagnose the age spots. But other skin conditions which can cause cancer such as actinic keratosis should be ruled out. A skin biopsy or dermoscopy can be done to rule out actinic keratosis.

Age Spots: Treatment

Treating the age spots is not compulsory as these are harmless. But, treating the age spots is important as it destroys one’s beauty, and usually individual doesn’t like the appearance which also can reduce self-confidence hence should be treated to reduce or lighten the age spots. The treatment includes −

• Pharmacological therapy − Some of the medications can lighten the age spots. These include bleaching creams like hydroquinone and retinoids can also be used. In some patients, mild steroids have also been shown to be effective

• Laser therapy − laser therapy can help people with age spots by causing damage to the melanin-producing cells and it does not the skin surface. Laser therapy is done in several sittings

• Cryotherapy − In this, the lesion is destructed by freezing. Cotton bud or cryospray is used and freezing is done for 20 to 30 seconds. It causes pain and healing are usually seen in 10 days. Liquefied nitrogen is usually used as the freezing agent.

• Dermabrasion − It is the procedure in which a rotating brush is rolled over the age spots. It acts by removing the skin surface and a new layer of the normal skin is later formed replacing it.

• Chemical peeling − In this technique, the skin is treated with an acid that burns the skin layer having age spots or pigmentation and later allows the development of a new skin layer.

Age Spots: Prevention

The development of age spots cannot be completely prevented as one cannot stop aging but the occurrence of the age spots can be delayed by following some of the measures. These include −

• Avoid longer exposure to the sun. the lesser the exposure lesser is the risk of getting age spots

• Wear sunscreen lotions when going out

• Covering the sun-exposed areas for more protection against the sun

Conclusion

Age spots or liver spots are age-related spots that are seen after the age of 50 years. Increasing age and increased exposure to the sun are the main risk factors as well as the cause of the development of age spots. These are caused mainly because of the excess amount of melanin production which acts by increasing the pigmentation of the skin and hence making the skin darker. These mainly occur in the skin-exposed areas

There is no need for any laboratory investigations to diagnose the age spots but can be ruled out from pre-cancerous skin lesions. Age spots are harmless and do not lead to any cancer. Treating them may not be much important as they do not cause any harm but should be treated if the person feels a loss of confidence as it affects the normal appearance of the skin. It can be treated by various methods such as by using creams of hydroquinone, laser therapy, chemical peeling, and dermabrasion and by cryotherapy.