Age spots, known medically as lentigos and seborrhoeic keratoses, are brown patches which commonly appear on the back of the hands, the face, and the back. Heredity and sun exposure are largely responsible for this excess melanin production in the skin. Several treatment options are available to rid the body of age spots.

Cryotherapy

Until recently the treatment of choice for age spots was cryotherapy With this technique liquid nitrogen is sprayed very gently on the spots to induce a localized frostbite. After two or three weeks the treated age spot peels off as the underlying skin pushes to the surface, leaving a residual area of pinkness that might last for only a week but could linger on for months. Scarring may occur.

Laser therapy

With the advent of the pigment removal lasers (Q switched ruby, Alexandrite, and Nd:Yag), cryotherapy is no longer the treatment of choice, because the laser has a lower risk of scarring, is less painful and the recovery time is shorter. Due to the cost of laser treatments and because not all physicians have access to a laser nor are they trained in laser surgery many individuals still choose cryotherapy to treat their age spots. The pigment removal lasers have also superseded the use of surgical removal or vaporization with the carbon dioxide laser for larger growths provided they are not too thick. If the lesion is suspected to be cancerous then a biopsy is always taken prior to proceeding with laser surgery so it can be analyzed by a pathologist. If it is malignant then surgical removal is used to ensure that the cancer has been completely removed. The carbon dioxide laser in its cutting mode may be used to do the surgical excision.

The age spot removal lasers act in a similar fashion to a guided missile. The light from the laser has a selective affinity for brown discoloration in the skin. It passes harmlessly through the top layer of skin and when it hits the brown pigment cells energy is released causing the melanosomes in the cell to break into minuscule particles which are removed by the body's immune system.

Each pulse of laser light feels like the snap of an elastic band on the skin. The age spot turns grey initially, then within minutes forms a superficial brown crust. Within 2 weeks the crust will be sloughed and the skin underneath will be pink. This gradually fades to the color of the surrounding skin over the course of 2 to 3 weeks. It takes less time for age spots to turn over on the face than on the back of the hands. The crusts must not be picked or rubbed off otherwise a scar will result.

Bleaching Creams

Prescription bleaching creams containing kojic acid or hydroquirione cause age spots and irregular pigmentation to fade so that they blend with the color of the surrounding skin. Reversa HQ and NeoStrata HQ are examples of over the counter gels containing glycolic acid and bleaching agents which are effective in lightening age spots and other irregular pigmentation in the skin. It is important to protect yourself against the sun with a broad spectrum sunscreen such as Ombrelle 15, otherwise you will defeat the purpose of the bleaching creams.

Medicated Creams

Tretinoin in preparations such as Retin A, Stieva A, Rejuva A, Retisol A, Renova and Vitamin A Acid, when applied to the back of the hands daily over a period of months gradually causes age spots to disappear, evens out irregular pigmentation, and reduces fine wrinkles giving the hands a more youthful appearance.

Chemical Peels

Acid containing solutions are also effective in removing age spots. They cause irritation and the spots peel away from the skin. The new underlying skin is pink and fades to a normal hue after a few months.

Camouflage Makeup

Opaque makeup can be used daily to camouflage age spots. Given the excellent medical options for removing age spots or lightening these discolorations of the skin, makeup becomes a less desirable alternative.