Few people are overjoyed with the aging process, but even less so if age spots show up. Fortunately, a wide variety of treatment options can remove these pesky-but-harmless dark areas on your skin, according to dermatologist Meryl Joerg of Advanced Dermatology P.C. 

Dr. Joerg
Colloquially called liver spots, though the liver isn’t involved in their development, age spots or solar lentigos typically appear on areas of the body that are most exposed to the sun. Commonly affected areas include the face, chest, back of hands, shoulders, arms and tops of the feet. Adults over 50 are most likely to get them, but age spots can occur in younger adults as well – especially those who spend a lot of time in the sun.
“These flat, round, oval or irregular areas of increased pigmentation result from an increased number of melanocytes, the cells that contain melanin that give skin its colour,” explains Dr. Joerg. “Solar lentigos vary in size and can appear tan to brown or even black. They can sometimes cluster together becoming more obvious. Although these are harmless, they are a sign of sun damage and these patients should be checked for skin cancer on a regular basis. Some patients are embarrassed by these sun spots and fortunately we have many ways to decrease their appearance.”
 
Risk factors for age spots 
They’re more common in people with light skin, but age spots can show up on any skin tone. What are some other risk factors for developing them? According to Dr. Joerg, they include:
·        Using commercial tanning lamps or tanning bed
·        Being exposed to the sun frequently or for long periods
·        History of sunburns
Of course, risk factors for age spots happen to overlap with risk factors for developing melanoma, a serious form of skin cancer. Age spots aren’t the same thing and don’t lead to melanoma, but it’s wise to have any skin changes seen by a doctor, Dr. Joerg advises. A biopsy will be done if a spot seems suspicious, though doctors can accurately diagnose most age spots just by looking at them or by using a dermatoscope, a handheld device that magnifies and enhances skin lesions.  
“You should especially watch out for spots that have an irregular border; are darkly pigmented; are rapidly growing in size; include an unusual combination of colors; or are accompanied by itching, redness, tenderness or bleeding,” she says. “Age spots can resemble cancerous growths, but age spots don’t actually need treatment – unless you want your age spots to disappear or become less noticeable.”
Tips for treatment and prevention 
Treatment for age spots fall under two main categories: topical creams and lotions, or procedures. Topical medications can include prescription-strength bleaching creams used alone or with retinoids and a mild steroid. Other fade creams and lotions are available over-the-counter and may include hydroquinone, glycolic acid or kojic acid, Dr. Joerg says.
If you desire a more aggressive approach to get rid of your age spots, procedures that may help include:
·        Fractional laser resurfacing: these procedures break apart the lentigos and the skin’s surface with a “controlled damage” technique and allow for new skin to fill in and repair the surface layer of the skin, where age spots occur.  
·        Laser and intense pulsed light therapy: These therapies destroy melanin-producing cells in the skin responsible for age spots but don’t damage the skin’s surface.
·        Freezing, also called cryotherapy: Liquid nitrogen or another freezing agent is applied to the skin to destroy excess pigment.
·        Chemical peel: An acid is applied to the skin that destroys the epidermis where the pigment is.
All age spot procedures typically require more than one treatment to maximize the effects. And all necessitate patients to rigorously control their sun exposure to help prevent age spots from recurring.
But whether you’ve lightened your age spots using home treatments or in-office procedures, avoiding the sun is key. Dr. Joerg stresses the necessity of wearing sunscreen, hats, and sun protective clothing to avoid a recurrence of the sun spots and to protect against skin cancer.
“Common-sense measures can help you stop new age spots from forming,” she says. “Avoid the sun between 10 am and 2 pm, use sunscreen religiously and cover up when you’re outdoors. We can’t stop ourselves from aging, but we can hinder age spots from developing and giving away our age.”
Meryl Joerg, M.D., is board certified dermatologist with Advanced Dermatology P.C.