Summary about Disease
Lentigines, commonly known as liver spots or age spots, are small, sharply circumscribed, pigmented macules (flat spots) on the skin. They are benign (non-cancerous) lesions that typically appear in areas exposed to the sun, such as the face, hands, shoulders, and upper back. While they are often associated with aging and sun exposure, they can occur in younger individuals as well. There are different types of lentigines, including solar lentigines (caused by sun exposure) and simple lentigines (which can appear at any age and may not be related to sun exposure).
Symptoms
Small, flat, brown or black spots on the skin.
Well-defined edges.
Typically appear on sun-exposed areas.
Usually painless and asymptomatic.
Vary in size, generally ranging from a few millimeters to about a centimeter in diameter.
Causes
Sun exposure (Solar Lentigines): Prolonged or excessive exposure to ultraviolet (UV) radiation from the sun is the most common cause.
Tanning beds: Artificial UV radiation can also contribute to the development of lentigines.
Genetics: A predisposition to developing lentigines can be inherited.
Age: As skin ages, it becomes more susceptible to sun damage and pigment changes.
PUVA therapy: A type of light treatment for skin conditions like psoriasis.
Rare genetic syndromes: Some rare genetic conditions can cause multiple lentigines to appear.
Medicine Used
Topical retinoids: Such as tretinoin, can help lighten the spots.
Topical corticosteroids: Applied with other lightening agents for short-term, under doctor supervision.
Hydroquinone: A skin-lightening cream that can reduce the appearance of lentigines. (Use with caution, potential side effects)
Chemical peels: Alpha-hydroxy acids (AHAs) or trichloroacetic acid (TCA) peels can remove the outer layers of skin.
Cryotherapy: Freezing the spots with liquid nitrogen.
Laser therapy: Different types of lasers can target the pigment in the lentigines, such as Q-switched lasers.
Intense Pulsed Light (IPL) therapy: Similar to laser therapy, IPL can also be used to fade lentigines.
Is Communicable
No, lentigines are not contagious. They are not caused by an infection and cannot be spread from person to person.
Precautions
Sunscreen: Use a broad-spectrum sunscreen with an SPF of 30 or higher daily, even on cloudy days.
Protective clothing: Wear hats, long sleeves, and sunglasses to shield your skin from the sun.
Limit sun exposure: Avoid prolonged sun exposure, especially during peak hours (10 AM to 4 PM).
Regular skin exams: Check your skin regularly for any new or changing spots, and consult a dermatologist if you have any concerns.
Avoid tanning beds: Tanning beds emit harmful UV radiation that can increase the risk of lentigines and skin cancer.
How long does an outbreak last?
Lentigines are not an "outbreak" like a rash or infection. They are permanent skin changes. Once a lentigo appears, it will typically remain unless treated with a cosmetic procedure or topical medication. New lentigines may continue to develop over time with continued sun exposure or aging.
How is it diagnosed?
Visual examination: A dermatologist can usually diagnose lentigines by simply looking at them.
Dermoscopy: A dermatoscope (a handheld magnifying device with a light) can be used to examine the skin more closely.
Skin biopsy: In rare cases, a skin biopsy may be performed to rule out other skin conditions, such as melanoma, especially if the spot has irregular borders, uneven color, or is rapidly changing.
Timeline of Symptoms
Lentigines develop gradually over time, usually after years of sun exposure.
Initial stage: A faint, small, light brown spot may appear.
Progression: The spot gradually becomes darker and more defined.
Stable stage: The lentigo remains a stable size and color unless treated. New lentigines may appear over time.
Important Considerations
Rule out melanoma: It's essential to have any new or changing spots evaluated by a dermatologist to rule out melanoma, a type of skin cancer that can sometimes resemble a lentigo.
Cosmetic concerns: While lentigines are benign, many people seek treatment for cosmetic reasons.
Prevention is key: Protecting your skin from the sun can help prevent the development of new lentigines.
Not a sign of liver disease: The term "liver spots" is a misnomer; lentigines are not related to liver function.