Age spots

Introduction

Age spots (also: lentigines seniles, lentigines solares) are brownish, harmless pigment changes on the skin, which increasingly occur with advancing age.

Appearance and localization

Age spots belong to the benign pigment spots, just like moles or freckles. They are usually light brown, sharply defined, several millimetres to centimetres in size and permanently visible in the same intensity (in contrast to freckles). Age spots are particularly common in the: In principle, age spots can form on any person.

However, as the name suggests, they become more frequent with increasing age. From the age of 40 onwards they are more frequent, from the age of 60 onwards over 90% of people have age spots. The age of manifestation and the degree of severity depend, among other things, on the extent of exposure to UV radiation and the skin type (people with fair skin develop mild age spots). Age spots always develop on the basis of long-term UV radiation of the skin. – on the face

  • By the hand
  • The forearms and
  • At the neckline

Causes of age spots

In addition to UV exposure, there are, however, other risk factors for the formation of age spots, including

  • A genetic predisposition
  • Certain drugs
  • Nitrate/nitrites from food, or
  • The consumption of alcohol and/or cigarettes.

Development of age spots

This paragraph requires medical knowledge and is therefore only for very interested laymen! Ultimately the age spots represent a deposit of the so-called age pigment lipofuscin in the epidermis. Due to an accumulation of this pigment it is no longer possible for the lysosomes to break it down in sufficient quantities, as is common in healthy skin.

Lipofuscin is the end product of the oxidation of unsaturated fatty acids which are located in the cell walls. UV radiation has the following effects on this process: UV light causes the formation of so-called free radicals. These are molecules that are extremely reactive and thus promote oxidation.

Furthermore, UV rays cause the amount of antioxidants in the skin to decrease. These antioxidants (for example zinc, selenium, coenzyme 10, vitamin C, vitamin E and carotenoids) form a protective system that normally helps the skin to protect itself well against free radicals. This means that the skin is doubly at risk for the formation of age spots as a result of intensive exposure to the sun and it also explains why these areas of the skin are often exposed to the sun. However, why they are only small and locally limited could not be conclusively clarified until today.

Symptoms of age spots

Apart from the typical skin changes, age spots show no other symptoms. Sometimes age spots develop into age warts (seborrheic wart, verruca seborrhoica). A malignant degeneration of the benign spots is not described.

Nevertheless, it is sometimes useful to clarify whether it is not a skin cancer, as certain forms of skin cancer, especially the lentigo-maligna melanoma, or a precancerous stage, the actinic keratosis, may have great similarities with age spots. This topic may also be of interest to you: How to recognize skin cancer The diagnosis of age spots is mostly possible by the affected person himself due to their characteristic appearance. However, because of the danger of confusion with malignant changes, if there is any uncertainty, one should consult a doctor, preferably a dermatologist (dermatologist), and have the skin changes examined.

In order to confirm the diagnosis, the doctor uses reflected-light microscopy (dermatoscopy). During this examination, a so-called dermatoscope (a device with a lens system consisting of a collecting and a dispersing lens and a halogen lamp) is directed at the affected areas, allowing a good assessment of the pigmentation. Even if the doctor cannot reliably exclude a skin cancer, he can take a tissue sample (biopsy) from the spot, which is then examined under the microscope, thus enabling tumour detection or exclusion.