Brown discolorations on the face, hands and decollete: age spots, also known as sun spots, are often a sign that the skin has been exposed to too much sun in the past. But how do you get rid of them again?
From: Susanne Wimmer
Twenty years ago, Sigrid Ehrle was not as careful about sun protection as she is today. At that time she lives in the south of France – it is common to be on the beach with the first rays of the sun in March. Putting cream on them? By no means. Sun protection with sun protection factor four was already the highest of feelings at that time, says Sigrid Ehrle. The 55-year-old fears that she will now have to pay the price:
"I lived there permanently for seven years. Then of course, as my dermatologist confirmed to me, it’s sun damage. At first you don’t notice it so much, but then all of a sudden it’s damage."
Hide the hands
For her, it starts in her late 40s. Unattractive, irregular spots appear especially on the hands. Soon they can no longer be overlooked.
"So I started to hide the hands. Because it is simply in comparison to colleagues or friends so that I say, we are the same age, but my hands look as if they were ancient."
Age spots: What really helps?
Sigrid Ehrle tries bleaching creams and mild peelings from the pharmacy. On the face, the spots recede easily. But not on the hands. Finally it is enough for her. She goes to the dermatologist and has laser treatment done. It’s been ten days now and Sigrid Ehrle is a little worried. Only today the skin started to flake off. Underneath she can see scar tissue. She would like to know from her dermatologist whether this is normal.
"The backs of the hands unfortunately take a long time to heal. Three times as long as the face. It’s not entirely untypical to have to wait three weeks for these little crusts to fall off. The later they fall off, the nicer the result. Because the skin underneath can regenerate completely again."
Dr. med. Hans-Peter Schoppelrey, dermatologist, Munich
Cause of age spots
Age spots have various causes. Genes play a role, plus environmental influences. When the skin is exposed to the sun, the dark pigment melanin is produced. It protects against the dangerous UV radiation. However, if this becomes too strong, melanin can accumulate in individual areas. How age spots develop.
Who knows the cause, can prevent. The best way is to protect the skin with clothing and use UV protection with a high sun protection factor. But if it’s already too late for that, here are some ways to remove age spots.
Have age spots lasered
The most effective method to get rid of age spots is laser treatment. In the process, a high-intensity beam of light penetrates the upper layers of the skin and shatters the pigment deposits into tiny particles. These are later carried away in the body. After the treatment, there may be slight swelling and a burning sensation, similar to sunburn. After two to four weeks, everything should have subsided completely.
It is important to use UV protection and avoid direct sun afterwards. Treatment is therefore ideal during the winter months. The cost of laser treatment ranges from 100 to 500 euros. They depend on the size of the treated skin area and possible extra services.
Laser therapy only by experienced doctors
There are now many providers, but caution is advised. Otherwise, there is a risk of overlooking malignant skin changes or accidentally including them in the laser treatment. Because what looks like a harmless age spot at first glance can, under certain circumstances, be a dangerous melanoma.
"In the best case, the melanoma is lasered away before it makes any settlements. In the worst case, cells could be loosened by the wrong laser treatment of a malignant skin change, penetrate into the body and then make metastases."
Dr. med. Hans-Peter Schoppelrey, dermatologist, Munich
Prof knows how easily a melanoma can be mistaken for an age spot in the practice. Sabine Plotz. She herself has collected examples of inconspicuous-looking melanomas for a textbook.
"In fact, melanomas can present themselves quite harmlessly. Only as a light red or even light brown spot."
Prof. Dr. med. Sabine Plotz, dermatologist, Munich
Cryotherapy: Icing age spots
The Munich dermatologist relies, among other things, on so-called cryotherapy to remove age spots. Here the skin surface is iced with liquid nitrogen. The pigment-bearing cells virtually freeze to death. New cells form underneath.
According to Plotz, this method works well for patients with single large pigment spots on the face. Sometimes, however, the spot does not disappear right away. Then another treatment is necessary.
The procedure is comparatively inexpensive. But many practices now find it too costly to keep the nitrogen they need in stock on a regular basis. In rare cases, scars or pigment shifts can develop – i.e. light or dark discolorations.
Certain peels can also help
Another method against age spots are peelings, for example based on salycil or trichloroacetic acid. The chemical acids wear away the upper layers of the skin. Patients feel a burning sensation after treatment. After two to three days, the skin begins to peel off. Success, according to Prof. Plotz, cannot be guaranteed in all cases. But as a rule it works well. While mild fruit acid peels only have a superficial effect, these applications penetrate deeper into the skin. Therefore, they must also be performed by experienced personnel.
"The difference is the penetration depth and that the peeling effect is also much stronger. Patients usually experience a strong redness and also a strong scaling after the treatment, and this is also desired."
Prof. Dr. med. Sabine Plotz, Dermatologist, Munich
Bleaching creams
For pre- and post-treatment, Sabine Plotz uses bleaching creams that additionally inhibit the formation of melanin. They contain the active ingredient hydroquinone and vitamin-A. The dermatologist considers over-the-counter creams to be ineffective because they may only contain small concentrations of them.
Age spots can come back?
Unfortunately, there is no guarantee that age spots, once removed, are gone forever.
"Very many of the spots are gone for life. However, if patients are exposed to the sun, such spots can come back after three to four years, or new ones can develop, of course."
Dr. med. Hans-Peter Schoppelrey, dermatologist, Munich
When pigment spots appear, change or grow quickly, they should be shown to the dermatologist.
Treatment success
After having her hands lasered, Sigrid Ehrle also had pigment spots on her face lasered. Four weeks later she proudly shows us the now healed spots. The spots are gone. The result on the hands is even more impressive. Except for a few delicate spots that look like freckles, there is nothing left to see.
"At first it was unusual to have nothing on the hands, really no spots at all. Where previously the reflex was to hide the hands immediately."
She is happy to have taken this step and would do it again at any time. No longer having to hide her hands because of age spots – a good feeling for Sigrid Ehrle.