Solar Lentigines (Age Spots)
Symptoms
Solar lentigines are flat, tan to dark‑brown macules with well‑defined borders on sun‑exposed skin such as the face, hands, shoulders, and arms. Lesions vary from a few millimeters to over a centimeter. They are asymptomatic but cosmetically concerning for some patients. The number and size increase with cumulative UV exposure. They do not fade in winter unlike freckles.
Cause
Chronic ultraviolet radiation induces melanocyte proliferation and increased melanin production in localized areas. Genetic factors and lighter skin phototypes increase susceptibility. Tanning beds accelerate formation. Lentigines are benign and not precancerous but signal significant sun damage. Oxidative stress and photodamage contribute to lesion development.
Treatment
Broad‑spectrum sunscreen and sun‑protective clothing prevent new spots and darkening of existing ones. Topical fading agents such as hydroquinone, retinoids, or alpha‑arbutin gradually lighten pigmentation. Cryotherapy, chemical peels, or laser therapies (Q‑switched or IPL) offer rapid clearance. Multiple sessions may be needed for stubborn lesions. Post‑procedure sun avoidance prevents recurrence.
Dr. Beth Schulz-Butulis
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