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What are age spots (lentigo)?
Age spots are flat, brown to grey-brown pigment patches caused by a local build-up of melanin in the skin. They are also called lentigo, liver spots, lentigo senilis or lentigo solaris. The term "liver spots" is misleading: they have nothing to do with the liver, but get their name from their brown colour.
There are three types. Solar lentigo is by far the most common: it is caused by years of UV exposure and typically appears after the age of forty on sun-exposed areas of skin. Lentigo simplex is a benign variant that can also appear in younger people, including on protected skin, and requires no treatment. Lentigo maligna is the rare but more serious exception: it has uneven pigmentation, irregular borders and can in some cases develop into melanoma, a serious form of skin cancer. Lentigo maligna always requires assessment by a certified dermatologist.
Wondering about the difference between an age spot and a mole? We explain it step by step on that page.
Do you suffer from Lentigo / Ouderdomsvlekken?
Have your skin assessed by a licensed dermatologist via the Skindr app. Upload photos and get a diagnosis with personal advice within 48 hours. No waiting room, no referral required.
How do age spots form?
Age spots form when UV radiation stimulates melanocytes (the pigment cells in the skin) to overproduce melanin. With repeated exposure, this pigment builds up locally, resulting in a visible brown patch. This process is gradual and speeds up as we get older, because the skin becomes less and less able to repair UV damage.
Certain factors increase the risk. A fair skin type that burns easily and rarely tans is a significant risk factor, as is years of sun exposure without adequate protection. Using a sunbed also substantially raises the risk of developing lentigo. PUVA therapy can also contribute to the formation of pigment patches.
Symptoms and characteristics of age spots
Age spots are flat, clearly defined and range in colour from light brown to dark brown. They are generally oval or irregular in shape and measure from a few millimetres to a few centimetres. An important characteristic is that they are not raised: you cannot feel a bump under your fingers. This distinguishes them from moles, which sometimes protrude slightly above the skin surface.
On a light skin tone, age spots are clearly visible as contrasting brown patches. On a darker skin tone, they are less obvious and appear as darker or greyish tonal differences.
Use the ABCDE rule to assess whether a spot warrants attention. A stands for Asymmetry, B for Border (irregular edges), C for Colour (colour variations within the same spot), D for Diameter (larger than 6 mm) and E for Evolution (is the spot changing?). Multiple anomalies may be a warning sign. If in doubt, have the spot assessed by a dermatologist.
Where do age spots appear?
Age spots almost always appear on areas that are regularly exposed to the sun. The most common locations are the face (cheeks, nose and forehead), the backs of the hands, the forearms, the décolleté and the shoulders. In people who do a lot of outdoor sport or wear little protective clothing, lentigo can also appear on the legs or back.
Lentigo simplex is the exception: it can also occur on sun-protected skin, such as the inner arms or the abdomen.
Do you suffer from Lentigo / Ouderdomsvlekken?
Have your skin assessed by a licensed dermatologist via the Skindr app. Upload photos and get a diagnosis with personal advice within 48 hours. No waiting room, no referral required.
Treatment of age spots
Age spots are not medically dangerous and do not require treatment. Most people nevertheless choose cosmetic removal, as the spots are experienced as bothersome. Before considering treatment, it is advisable to have the spot assessed by a certified dermatologist first, especially if you suspect lentigo maligna.
The most effective cosmetic option is laser therapy: a laser breaks down the excess pigment, causing the spot to gradually fade. Cryotherapy (freezing the spot with liquid nitrogen) also gives good results but carries a slightly higher risk of scarring. Chemical peels work more superficially and are better suited to scattered, less pronounced spots. Skin-lightening creams can make existing spots lighter but work more slowly than the procedures above.
Skindr does not carry out laser treatment or cryotherapy itself, but helps you determine the most suitable approach and refers you to a qualified practitioner.
Prevention is the best long-term strategy. Daily use of sunscreen with at least SPF 30 (even on cloudy days and in winter) significantly slows the formation of new age spots.
Via Skindr, you receive advice from a certified dermatologist within 48 hours.
What doesn't work for age spots?
Many products promise to remove age spots but disappoint in practice. Supermarket creams and cosmetic serums claiming to deliver "spot-free skin in 4 weeks" generally contain insufficient active ingredients for a noticeable result.
Self-treatment with aggressive products of unknown origin (highly concentrated acid mixtures or non-certified lightening creams) can irritate, damage the skin or cause scarring. The same applies to home remedies based on lemon juice or essential oils.
Seeking extra sun exposure to "tan away" the spots also has the opposite effect: existing lentigo becomes darker and new spots may form.
Frequently asked questions about age spots
What is the difference between an age spot and a mole?
Age spots are flat, uniform in colour and caused by years of sun damage. Moles are often slightly raised, darker and can be present from birth. If you are unsure what type of spot you have, have it assessed by a certified dermatologist.
Are age spots dangerous?
In most cases, age spots (lentigo solaris) are completely harmless. Lentigo maligna, a rare variant with uneven pigmentation and irregular borders, can develop into melanoma and always requires assessment by a dermatologist.
Can age spots disappear on their own?
No. Lentigo does not disappear spontaneously and can become darker with continued sun exposure. Cosmetic treatments such as laser therapy or cryotherapy can remove them effectively.
Can a dermatologist assess age spots online?
Yes. Via Skindr, you send photos of the spot to a certified dermatologist, who provides professional advice within 48 hours, without an in-person appointment.
Are Skindr consultations reimbursed in Belgium?
A Skindr consultation may be partially reimbursed by certain supplementary insurers, such as DKV, AG, Helan or Neutrale Ziekenfonds. Contact Skindr or your insurer for specific conditions.
Are age spots the same as liver spots?
Yes. "Liver spots" refers to the brown colour, not to a poorly functioning liver. The correct medical term is lentigo solaris or lentigo senilis.
Resources
- Skindr dermatologists: Clinical advice from the Skindr dermatological panel
- EBPNet — Belgian guidelines on skin lesions (ebpnet.be)
- DermNet NZ: Lentigo
- Huidarts.com: Age spots
- NHG Guideline Melanoma and Pigmented Lesions
