Age spots, lentigo senilis or lentigo solaris often appear in the later stages of a person’s life. As a rule, they are not dangerous but are merely benign skin changes. Mostly they are brownish and of different size. Age spots are most frequently found on the hand, face and chest. Nevertheless, it is advisable to also have age spots examined for changes by your family doctor or dermatologist at regular intervals.
What are age spots?
Age spots are pigmentary disorders of the skin. They result from a lifetime of exposure to sunlight. Age spots are light brown blotches predominantly on the backs of the hands, forearms and facial skin. Age spots, lentigo senilis or lentigo solaris are a sharply defined, light brown colored change in the skin associated with advancing age. They are changes caused by decades of exposure to various forms of radiation. Age spots are not dangerous at first and should only be observed when they newly appear. Most older people develop them sooner or later without them ever causing problems. In some cases, however, age spots can be a precursor to skin cancer that is still harmless, which means they need to be watched closely all the time – even if they have been present for several years.
Causes
Age spots are closely related to years of contact with ultraviolet radiation, such as from sunlight or from too frequent visits to a tanning bed. Anyone who has been outside in the sunlight almost constantly as a child is very likely to develop age spots at an older age. Age spots are also referred to as macules in medical terminology and are localized, sharply demarcated, light brown colored areas of the skin in which there is an increased formation of melanocytes, which are responsible for the production of the skin pigment melanin. Strictly speaking, age spots are a local accumulation of the pigment lipofuscin. The cell membranes constantly oxidize unsaturated fatty acids and in the process also shed this pigment. However, the cell’s lysosomes are no longer able to break down the lipofuscin, leaving it as an age spot on the skin.
Symptoms, complaints and signs
Age spots appear primarily where the skin has been frequently exposed to UV radiation over the course of a lifetime – for example, on the back of the hands, on the forearms, on the face, and around the décolleté. They usually appear after the age of 40, but can also affect younger people. Age spots usually have a brown-yellowish to dark brown color, whereas they can vary greatly in size and shape. Thus, some pigment spots are barely visible, while others reach a size of several centimeters. The shape is often reminiscent of a slightly convex lens, but can also be more oval and flat. In most cases, however, the spots appear slightly raised. In addition, age spots usually stand out strongly from the surrounding skin – similar to freckles. In contrast to these, however, they hardly fade in the cold season. Since they are merely pigment disorders, age spots do not cause any physical discomfort such as pain or itching. However, depending on how pronounced the skin changes are visible to others, those affected may suffer from more or less pronounced psychological pressure. Since the symptoms of age spots can be very similar to those of white and black skin cancer, a dermatologist should also be consulted in the case of any skin changes.
Course
Age spots practically do not know a documentable course of the disease. They develop spontaneously and only require that the affected person has been frequently exposed to UV radiation or solar radiation in younger years of life. Over the years, the disorder of cellular metabolism develops in the area of age spots, which ensures that the pigment lipofuscin can no longer be broken down. Most age spots will form over a short period of time and spread across the skin until they eventually find their local boundaries. If they are slow to spread or seem to keep growing, it should be assumed that they are no longer harmless.This would be more of a sign of uncontrolled growth that should be checked and treated by a physician.
Complications
Complications associated with age spots (lentigines solaris or seniles) are usually not to be feared. This is also true for untreated age spots, which are a cosmetic problem at best. Age spots consist of an accumulation of the brownish pigment lipofuscin. This is oxidized, incompletely degraded unsaturated fatty acids from cell membranes. In rare cases, an age spot can develop into a so-called age wart (seborrheic keratosis). These are benign, highly pigmented small skin growths that occur mainly on the face and upper body. It is very likely that age warts develop independently of sunlight exposure because they are based on predisposition, i.e. they correspond to a genetic predisposition. The age warts may also be a cosmetic problem. So far, no degeneration of the cells into black skin cancer or similar problematic cells has been observed. While for the removal of age spots, in addition to professional laser therapy, a number of suggestions for removal by home remedies exist, the same is not true for age warts. Conventional wart remedies are not suitable because age warts are not caused by viruses. The real danger with age warts is that in some cases the symptoms of black skin cancer have been mistaken for age warts and therapy has been delayed accordingly.
When should you go to the doctor?
Age spots arise from locally occurring harmless pigmentary abnormalities in the skin. Their appearance is favored by decades of exposure to sunlight, but also by a genetic predisposition. If there is a confirmed diagnosis that the pigment disorders are age spots and not dangerous skin changes as a precursor to white or black skin cancer, the problem is purely cosmetic. There is no immediate danger from them. Nevertheless, it is advisable to visually check the skin regularly yourself for locally conspicuous changes or to carry out the visual inspection with the help of your partner. Some skin changes with the potential to develop malignant skin cancer look similar to harmless age spots. A check-up of the skin appearance by the dermatologist at regular intervals appears to be useful in order to maintain the option of an early detection of skin cancer and thus to preserve the possibility of an early treatment. Regardless of regular routine examinations, an experienced dermatologist should be consulted immediately as soon as a conspicuous and unusual skin change appears. A number of treatment methods exist to have age spots, which are perceived as cosmetically very disturbing, removed by a dermatologist or even by an experienced general practitioner with the appropriate equipment. Laser therapy has been established as particularly effective, but a number of home remedies are also suitable for alleviating the cosmetic problem of age spots.
Treatment and therapy
Age spots are benign and therefore do not require special treatment. However, it is important to have the spot examined by a doctor when it appears to check its consistency. If it is indeed deposits of the substance lipofuscin, cosmetic methods of removal can be discussed with the doctor. Laser therapies for removal have been found to be particularly effective in combating age spots. Those who are afraid of such a procedure can also rely on treatment with fruit or vitamin A acid or use preparations containing retinol. To prevent age spots from returning, extreme contact with UV radiation should be avoided in the future. During treatment, it must always be considered that the age spot could be a so-called malignancy, i.e. skin cancer. Therefore, every new age spot should be examined by a doctor to ensure that it is not a dangerous neoplasm. This could otherwise lead to metastases if left untreated and become far more dangerous.
Outlook and prognosis
Usually, no treatment needs to take place for age spots.These spots are mainly promoted by direct exposure to the sun and do not lead to further complications or discomfort. For this reason, they do not need to be treated. Treatment is only necessary if the age spots change in shape, color or size. This may be a tumor, which should be removed in any case. Sometimes patients are ashamed of their age spots and feel uncomfortable with their bodies. Social discomfort can also occur. Especially younger people can develop strong depressive moods due to age spots, if the skin was not sufficiently protected. Usually, age spots can be treated with the help of lasers or medications. Although they cannot be completely limited, they can be relatively well reduced. The life expectancy of the affected person is not reduced by the age spots. Likewise, there are relatively many self-help remedies available to the patient to combat age spots.
Aftercare
Aftercare aims to prevent the recurrence of disease. However, age spots are by no means a disease. They are completely harmless. Therefore, scheduled medical treatment is not necessary. If a person wants to have the skin symptoms removed, this is usually not subsidized by a health insurance company. The reason for this is aesthetic criteria. Age spots appear with increasing age. They testify to the fact that those affected have been exposed to ultraviolet radiation in the course of their lives. If you want to prevent their appearance, you have to become active at a young age. Avoidance of strong sun exposure is considered essential protection. The use of sunscreen is a must in southern countries. Patients should avoid the particularly strong midday sun. Solariums should not be used under any circumstances. The removal of age spots is mostly done by laser therapy. Bleaching creams and chemical peels also lead to the desired result. After a spot has been treated, the sun must be avoided for weeks or even months. Of course, the characteristic skin change may reappear on other parts of the body. Then repeated treatment is necessary. For diagnosis, a doctor uses a halogen lamp and observes the age spots through a lens. In this way, he rules out skin cancer.
What you can do yourself
Age spots can be alleviated independently with the help of various home remedies and measures. Quick help promises, for example, concealer cream, which is applied to the skin in the form of a concealer stick or lotion. Natural remedies such as buttermilk, vinegar or lemon juice also provide the skin with moisture and fat. In addition, preparations with vitamin E can be taken. The active ingredient naturally lightens the pigments and, when applied locally, reduces the appearance of further age spots. Other natural remedies include garlic, lactic acid and the juice of parsley. Apple cider vinegar, potato juice, castor oil can also help against age spots. The above-mentioned remedies are effective especially in combination with skin-protecting measures. In particular, older people should avoid excessive sun exposure and care for the particularly sensitive skin areas on a daily basis. In addition, a balanced diet with foods rich in vitamins and minerals (spinach, peas, legumes, cabbage, etc.) is recommended. An alternative treatment method is cold therapy, in which the spots are lightened with liquid nitrogen. In some circumstances, the affected skin layers can also be peeled off. However, this so-called dermabrasion can leave stains and should always be done under medical supervision.
