What to know about age spots (liver spots)

Age spots are marks that commonly appear on the skin after prolonged sun exposure. They are harmless, but some people wish to remove them for cosmetic reasons.

Other names for age spots include solar lentigines and liver spots, though they have no connection to the liver.

These marks are flat and darker than surrounding skin. They can be tan, brown, or black, and they may resemble freckles.

In this article, we explore the causes and symptoms of age spots and describe safe ways to get rid of them.

What causes age spots?

Age spots commonly appear after sun exposure.
Image credit: DermNet, New Zealand

Age spots are a result of the body producing excess melanin. Melanin is the pigment that gives skin its color.

When the skin is exposed to sunlight, the body produces extra melanin to protect the skin from the sun’s ultraviolet (UV) rays.

The more melanin produced, the darker the skin becomes.

Age spots appear when excess melanin in the skin becomes clumped together.

Symptoms

Age spots usually appear in areas of skin that are commonly exposed to the sun, including the:

face
backs of the hands
shoulders
back
arms
tops of the feet

Age spots can develop singly or in clusters. They vary in size and may range from 0.2–2.0 centimeters in diameter.

Age spots tend to form in people aged 40 and over, though they can also develop in younger people who frequently get sunburns or use tanning beds.

These spots can form on anyone’s skin, though they are more common in people with lighter skin, which is more sensitive to the sun.

Diagnosis

A doctor will be able to identify age spots with a visual examination. They may use a dermatoscope, which is a hand-held magnifying tool that medical professionals use to examine areas of skin.

In some cases, it can be difficult to differentiate an age spot from melanoma, a type of cancer that forms in cells that contain pigment.

If a doctor is unsure, they may order a skin biopsy. This involves taking a small sample of the affected skin and sending it to a laboratory, where a technician will perform tests to determine the type of growth.

Treatment

A doctor may suggest cryotherapy to remove an age spot.

Age spots are harmless and do not require treatment. However, because they can resemble skin cancer, it is important that a doctor checks them out.

If a person wants to remove a confirmed age spot for cosmetic reasons, they have a variety of options.

Topical creams can lighten age spots. However, avoid lighteners that contain mercury, as they may pose a serious health risk. A healthcare professional can prescribe a product that is safe.

A prescription topical cream for lightening age spots may contain:

retinoids, such as tretinoin
cortisone
hydroquinone

These creams lighten spots gradually over time. They can sometimes irritate the skin, so it is best to discuss side effects with a doctor before deciding upon the right cream.

Some cosmetic procedures can also lighten or remove age spots. Before undergoing a procedure, discuss options with a dermatologist, or a doctor specializing in skin care.

The dermatologist may suggest one of the following procedures:

cryotherapy, which involves removing the spot with a cold substance, such as liquid nitrogen
laser surgery or intense pulsed light therapy, which involves using high-intensity beams
microdermabrasion, a non-invasive treatment that involves exfoliating the skin
a chemical peel, which involves brushing a chemical solution onto the skin to exfoliate it, then peeling away the dead cells

These procedures all carry risks and can scar the skin. According to the American Academy of Dermatology (AAD), a specially trained dermatologist should perform them.

These removal techniques can also make the skin extra sensitive to sunlight. Anyone who has undergone one of these procedures should take extra precautions in the sun and follow their doctor’s advice.

Home remedies

Natural remedies may also help lighten age spots. These include:

Aloe vera: Some research in animals suggests that applying aloe vera to age spots each day can lighten the marks.
Red onion: Results of one study indicate that dried red onion skin may lighten age spots. A person can look for topical creams that contain Allium cepa.
Orchid extract: Authors of another study concluded that orchid extracts may lighten age spots. The extracts are ingredients in some skin care products.

Topical creams can also reduce the appearance of age spots. Research suggests that creams containing one or more of the following ingredients may help:

Some people use makeup to cover age spots. A dermatologist or cosmetics salesperson can offer advice on useful products.

Prevention

People should use a water-resistant sunscreen that has UVA and UVB protection.

It is often possible to prevent age spots from forming.

The AAD recommend using a sunscreen with a minimum protection of SPF 30. It should be water-resistant and have UVA and UVB protection. Apply the sunscreen to exposed skin 15 minutes before going outdoors.

Results of a 2018 study indicate that using an SPF 30 cream every day can also prevent age spots from getting darker in the spring and summer.

Other ways to protect the skin and prevent age spots include:

reapplying sunscreen every 2 hours or after sweating or being in the water
covering the skin with a wide-brimmed hat, long sleeves, long trousers, and sunglasses
staying out of the sun during the hottest parts of the day, usually between 10 a.m. and 2 p.m.
refraining from using tanning beds
wearing a lip balm with SPF 30 or higher
wearing gloves when cycling or gardening for an extended period in the sun
taking extra precautions around water, snow, or sand, as these surfaces reflect the sun’s rays
wearing clothes with an ultraviolet protection factor, or UPF, of 40–50

Avoiding overexposure to the sun will also reduce a person’s risk of skin cancer.

Are age spots linked with cancer?

Age spots are not cancerous. They can sometimes resemble types of skin cancer, however, so it is important to be aware of the differences.

Skin cancer is more likely to develop in areas that have been exposed to the sun over a prolonged period.

Age spots can look like actinic keratosis (AK) growths, which are precancerous. However, age spots are flat, while AK growths usually feel rough.

Other issues to look out for include:

rough patches of skin that may be painful when rubbed
dry, scaly, pink or red patches of skin
white, scaly marks that look like warts

If a person suspects that they have AK growths, they should visit a doctor for an examination.

It is generally a good idea to consult a doctor about any unusual changes to the skin. If a doctor diagnoses skin cancer at an early stage, treatment has a high success rate.