Alternate Names: Sun-induced skin changes - liver spots; Senile lentigines; Lentigos; Skin spots-aging; Age spots

Causes and Risks: Liver spots are pigmentary changes associated with senile skin. The increased pigmentation may be brought on by aging, exposure to sun or other forms of ultraviolet light, or other unknown causes.

Liver spots are extremely common after 55 years old. They occur most often on the backs of the hands, on the forearms, shoulder, face, and forehead. These are the areas of highest sun exposure.

They are harmless and painless but may affect the cosmetic appearance.

Prevention: Minimize sun exposure. Avoid perfumes or after shave lotions before sun exposure, because they can increase sensitivity of the skin to sunlight.

Protect the skin from the sun. Wear protective clothing such as hats, long-sleeved shirts, long skirts, or pants. Use sunglasses to protect the eyes. Sunlight is most intense at midday, so try to avoid exposure during these hours. Use high quality sunscreens, preferably with SPF (sun protection factor) ratings of at least 15. Apply sunscreen at least a half hour before exposure, and reapply frequently. Use sunscreen for winter exposure also.

Symptoms:

• skin lesion that is a painless flat patch or macule (area of skin color change)
  • light brown to black
  • usually located on the hands, arms, and/or forehead

Signs and Tests: Diagnosis is based on the appearance of the skin, especially with a history of increased age or sun exposure.

Treatment: No treatment is needed in most cases. Cosmetic appearance may be improved by the use of skin bleaching lotions or creams. Cryotherapy (freezing) may be recommended to destroy the liver spot. Preventive measures should be taken to prevent recurrence or development of new spots.

Prognosis: Liver spots are not medically dangerous. They are permanent skin changes that may affect cosmetic appearance.

Complications:

• psychological distress from changes in cosmetic appearance

Call for an appointment with your health care provider if liver spots are present and removal is desired, or if any new symptoms develop, particularly changes in the appearance of any skin lesion.