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SUN SPOTS

Skin discolouration

Sun spots

Briefly

Sun spots are actually a discolouration of the skin, occurring as grey, brown or black flat spots. They vary in size and they usually occur on the face, hands and chest, i.e. on sun exposed areas. Contrary to freckles that become darker during the summer and fade in winter, sun spots do not fade without treatment. In most cases they are harmless but they should be examined by a dermatologist if there is a change of their colour or size. If they cause cosmetic concerns they can be treated with the use of lightening agents, Lasers and other effective treatments. Prevention is the best treatment method.

Symptoms

Sun spots seem to “prefer” more fair complexions than darker skin types. They are flat, oval shaped areas showing increased level of pigmentation. They are usually brown, black or grey. Extensive sun exposure of the skin areas such as the hands and feet, face, shoulders and the upper part of the body, for many years, usually leads to the appearance of the so-called sun spots.Their size varies – from small spots like freckles to larger ones, reaching 1 cm, while many times they occur in groups and they are more profound.

Changes in their shape or appearance require a doctor’s evaluation

While harmless in their majority, when they (age spots) change color or appearance a medical evaluation is required as these may be signs of skin cancer, that is melanoma. More specifically, a visit to your dermatologist is necessary if a lesion or a spot:

• Becomes significantly darker
• Increases rapidly in size
• Has irregular borders
• Has not a usual combination of colors
• Causes bleeding, tenderness or itching

Causes

Sun spots are caused primarily by years of exposure to ultraviolet (UV) light from the sun. The use of commercial Prolonged & frequent sun exposure is the most common reason for the development of sun spots whilst commercial tanning techniques, such as solarium, using tanning beds and/or lamps constitute also a contributing factor to the advancement of age spots. More specifically, melanin is the pigment in the top layer of the epidermis which gives the skin it’s regular color. The tan created by the acceleration of the production melanin caused by UV light protects UV rays to penetrate the deeper layers of the skin. Sun spots development to skin areas exposed for years to the sun come as a result of melanin’s over secretion. However, besides sun exposure, another possible factor for the development of sun spots is genetic predisposition.

Risk factors

Age spots are common to almost everyone. However, there are certain factors such as fair or light-colored complexion or history of long-term & consistent sun exposure or sunburns that are more likely to increase the odds of their development. 

Pre-appointment preparation

When you visit your dermatologist you should be prepared to answer the following questions:

  • When did you first notice the spots on your skin?
  • Did the spots appear gradually or quickly?
  • Have you noticed any other changes in the appearance of your skin?
  • Is the condition itchy, tender or otherwise bothersome?
  • Have you experienced frequent or severe sunburns?
  • How often are you exposed to sun or UV radiation?
  • Do you regularly protect your skin from UV radiation?
  • What kind of sun protection do you use?

Questions you may want to ask your doctor?

  • What suspicious changes in my skin should I look for?
  • If the spots are sun spots, what can I do to improve their appearance?
  • What is the expected result?

Tests and Diagnosis

For the diagnosis of sun spots the following may be required:

Visual examination: The doctor may diagnose the age spots through the careful examination of your skin.

Biopsy: A series of certain tests, such as a skin biopsy may be required to verify whether the skin lesion is actually an age spot or not. Skin biopsy results are based on the skin sample the doctor will take for further microscopic analysis. Skin biopsy is performed in a doctor’s practice with local anesthesia.

Other similar conditions

Other conditions that can look similar to age spots and that your doctor may need to rule out include the following:

  • Moles. Although they often appear as small, dark brown spots, moles (nevi) vary in colour and size. They can be raised or flat and can develop almost anywhere on your body.
  • Seborrheic keratoses. These tan, brown or black growths have a wart-like or waxy, pasted-on appearance.
  • Lentigo maligna. A type of skin cancer known as lentigo maligna melanoma can develop in areas of long-term sun exposure. Lentigo maligna starts as tan, brown or black lesions that slowly darken and enlarge. They tend to have an irregular border and uneven colouring, and they may be slightly raised.

Treatments and medication for sun spots

If you’re unhappy with the appearance of age spots, treatments are available to lighten or remove them. Since the If you’re unhappy with the appearance of age spots, there is a number of treatments available to remove or lighten them. The location of the spot at the higher layer of the skin, in other words, the base of the epidermis, requires all the treatments to penetrate the given layer in order to achieve the desired outcome.

For the treatment of sun spots the following methods are available:

  • Medications: Prescribed bleaching creams containing hydroquinone can be used either alone or in combination with retinoids as well as a soft steroid as they may lead to the gradual fading of the spots within the following months. Furthermore, the use of sun blocking products with SPF at least 30, is highly recommended especially when medication intake is involved. At times temporary redness, itching, dryness or burning may occur.
  • LASER: Laser therapy destroys the melanocytes, the cells that produce melanin, leaving the skin surface intact. Laser treatment typically requires a number of sessions & to have hardly any side effects, however, it may lead to a slight skin discoloration as age spots gradually fade over the following weeks or months. The use of sunblock is strongly recommended after the therapy.
  • Cryotherapy: The procedure involves the application of a freezing agent or liquid nitrogen directly either to a single or a small group of age spots. As the healing process progresses the skin seems lighter. Patients undergoing freezing procedure may experience temporary irritation of the skin while at times the procedure may pose a small risk of permanent discoloration or scarring.
  • Dermabrasion: A very rapid rotating brush smoothes the outer layer of the skin. What actually happens is that dermabrasion “peels off” the surface of the skin for the new layer of skin to grow in the latter’s place. Patients may experience a temporary redness or formation of scabs.
  • Chemical peel: The procedure involves the application of an acid to burn the external skin layer, to the spots. While the peeling of the skin is in progress, new skin is formed and takes the latter’s place. Chemical peel requires a number of treatments before the patient notices any sort of results. The use of sunblock is highly recommended throughout the treatment. Patients may experience temporary irritation while the possibility of discoloration is not excluded.

Home treatments

There are many over-the-counter products available in the market for the lightening of sun spots. Despite the fact that their application may lead to the improvement of the spots, it may take a significant period of time to finally produce worth noticing results. The gradual lightening of the sun spots using OTC products depends on their pigmentation, how dark they are, and on the application frequency. Regular use is required. OTC products that contain glycolic acid, kojic acid or hydroquinone are recommended, if you decide to proceed this way. However, it’s worth noting that certain products, particularly those containing hydroquinone are likely to cause irritation of the skin. .

Prevention

To avoid sun spots, you can follow the tips provided below to limit the time of sun exposure:

Avoid the sun between 10 a.m. and 3 p.m. Because the sun’s rays are most intense during this time, try to schedule outdoor activities for other times of the day.

Use sunscreen. Fifteen to 30 minutes before going outdoors, apply a broad-spectrum sunscreen that provides protection from both UVA and UVB light. Use a sunscreen with a sun-protection factor (SPF) of at least 30. Apply sunscreen generously, and reapply every two hours — or more often if you’re swimming or perspiring.

Cover up. For protection from the sun, wear a broad-brimmed hat, which provides more protection than does a baseball cap or golf visor, and tightly woven clothing that covers your arms and legs. You might also consider wearing clothing designed to provide sun protection.

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