Sun Exposure and "Age Spots"

Q:  I have seen many ads for products that are supposed to reduce the appearance of age spots. Are these products worth spending money on?

For that matter, what exactly are age spots? Does anything really make them go away?

A:  "Age spots" look like big freckles: they are flat and brownish but wider than a centimeter across. They are commonly found on sun-exposed areas like the face, hands, and lower arms. While freckles appear in children and can darken with the sun, age spots are due to a cumulative exposure to sunlight, do not change in color, and usually occur after the age of 40. Sometimes they are called "liver spots" but, in fact, they have nothing to do with the liver.

You do not need to treat age spots. However, if you do not like the looks of them, there are several options. Your doctor or dermatologist may freeze them with liquid nitrogen. You may buy a bleaching lotion containing hydroquinone (often labeled "fade cream") at your local pharmacy, or your doctor may prescribe hydroquinone at a higher concentration.

Dr. Janet Fairley, Professor of Dermatology at the Medical College of Wisconsin, tells me that some products advertised for "age spots" can be beneficial. These combine hydroquinone, tretinoin (a medicine that treats acne under the brand name RetinA), and a cortisone cream. Like any product containing hydroquinone, these products, must be used with sunscreen to be effective. Sunscreens are also a useful way to prevent new age spots, but they will not lighten present ones.

By the way, with the spring and summer months just ahead of us, this is a good time to remind people about the damaging effects of sun exposure and how to avoid them.

In addition to skin cancer and sunburn, overexposure can cause wrinkling, premature aging, and in time, an almost leathery appearance of the skin. Skin damage from sunlight builds up with continued exposure, whether sunburn occurs or not. Research also suggests that excessive exposure to UV radiation from sunlight might interfere with the body's immune system.

According to the Food and Drug Administration (FDA), sunscreens are an important part of a person's total sun protection strategy, but sunscreen alone will not prevent all of the possible harmful effects of sun exposure. In addition, you should cover exposed areas with tightly woven clothing and wear a wide-brimmed hat to protect your head and face. If you are taking care of children, protect their skin as well as your own. Research indicates that one or more severe, blistering sunburns in childhood or adolescence can double the risk of skin cancer later in life.

Remember that the sun's rays are the strongest from 10:00 a.m. to 4:00 pm, especially during the late spring and summer. Reflected glare from water can also increase your exposure to UV radiation.

The effectiveness of a sunscreen is reduced if it is not applied in adequate amounts or it is washed off, rubbed off, sweated off, or otherwise removed. For maximum effectiveness, apply a sunscreen liberally and reapply it frequently.

To help consumers select products that best suit their needs, sunscreens are labeled with SPF numbers. SPF stands for "Sun Protection Factor." The higher the SPF number, the more sunburn protection the product provides.

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices internal medicine at the Froedtert & Medical College General Internal Medicine Clinic - East. Her column appears in the Milwaukee Journal-Sentinel.