DEAR DR. GOTT: I am a 50-year-old light-skinned black female with dark spots on my face. My doctor says they are age spots. I have never smoked or consumed alcohol, nor have I ever worn makeup. Is there any over-the-counter product that is affordable you might recommend?
DEAR READER: Liver spots, also known as age spots, are common in people who are over the age of 40 and in those who may have had chronic sunlight exposure without protective sunscreen. The spots are harmless and do not require treatment. They typically appear on light-skinned people but can affect anyone. Exposure to ultraviolet light speeds up the production of melanin, the dark pigment in the outer layers of skin that give it color. Additional melanin is what creates the darker color, primarily in Caucasians, known as a tan. When melanin clumps into higher-than-normal concentrations, age spots appear. What many of us fail to realize is that people of African descent are as susceptible to sun damage as are fair-skinned Caucasians.
If you are put off by the appearance of the spots, start with a referral to a dermatologist. There are several treatment possibilities. Prescription creams that bleach the skin might fade the spots over a period of several months. There are many choices from which to choose and this is the least expensive therapy, depending on how often the cream is applied and how dark the spots are. In order for treatment to be successful, the cream or lotion must penetrate through the top layer of skin where the excess pigment is located. This method of treatment might take weeks or months before progress is seen.
Beyond creams and lotions, cryotherapy applies a freezing agent such as liquid nitrogen to the spots, breaking up the areas that contain the excess pigment. Laser therapy, while expensive, can destroy the excess melanocytes that created the darkened areas of pigment. There is no damage to the surface of the skin with lasers, and results are apparent over a period of several weeks or months. Chemical peel involves applying an acid application to the outer layer of the skin where the age spots appear. The skin then peels, new skin forms, and the spots are no longer present. Dermabrasion sands down the surface of the skin with a brush that rotates rapidly. Again, this removes the surface skin, a new layer grows, and the spots disappear. This process may leave temporary scabbing and redness.
To avoid future age spots, protect your skin — primarily that on the backs of your hands, face, shoulders and upper back — with a sunscreen applied about a half-hour prior to exposure. Then reapply it in a timely manner according to the manufacturer’s recommendations. Wear protective clothing when out of doors that might include a wide-brimmed hat, long-sleeved shirts and long pants.
Should any of your lesions change in color, enlarge, raise or modify in unusual ways, be sure to return to your physician for evaluation because skin cancer can develop from long-term sun exposure.
To provide related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44091-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
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