I’m almost halfway through my thirties, and I’ve recently noticed some skin spots that I remember seeing on the arms of my grandmother and aunts when I was growing up. I always heard them called “liver spots,” which sounds a little unnerving to me. So I started thinking, “Are the spots evidence of liver troubles? Are they a sign of premature aging?”
I took my questions to Daniel Zaghi, MD, MS, a dermatologist on the medical staff at Baylor University Medical Center at Dallas.
Q: What are liver spots?
Liver spots or old age spots, also known as solar lentigines, are very common tan, brown or black spots on the skin. While they can appear anywhere, they often occur on sun-exposed locations like the face, upper chest and back, arms and hands.
Liver spots are usually due to many years of ultraviolet (UV) exposure from the sun. The more our skin is exposed to UV light, the more it creates a pigment called melanin to block the UV light from damaging the genetic information inside cells.
Age spots are most common in people over the age of 40, though they can be seen in much younger patients. Those at greatest risk for the development of age spots includes patients with fair skin, outdoor occupations, or a history of tanning, radiation or light therapy.
Q: Are they troublesome? Are they a potential indicator of cancer?
Liver spots are not pre-cancerous, though they are often troublesome from a cosmetic perspective. This is especially true given that liver spots target those areas of our skin that are most visible.
Q: What do liver spots look like?
Liver spots look like oval or round flat brown, tan or black splotches on the skin. They vary in size from a few millimeters to two centimeters. They are usually smooth to the touch and uniform in color. Some patients have just a few while others may have hundreds on their skin.
Q: If they have nothing to do with the organ, why are they called “liver spots”?
They were thought to have derived from the liver, but we now know that is not the case.
Q: Do liver spots run in families? Did I inherit the tendency to develop them?
You may have! Your genetic makeup, including the color of your skin, does influence your ability to develop liver spots. But remember, like so many other disorders of the skin, a combination of genes and the environment contribute.
Q: Do we need treatment if we have liver spots?
True liver spots are completely harmless and do not require treatment.
However, liver spots are often upsetting to patients, particularly when they affect the face or backs of hands. For these patients, lots of options are available, ranging from mild lightening of the discoloration to complete removal.
Treatment options include topical medicines, freezing with liquid nitrogen, laser therapy, dermabrasion or chemical peels. Many of these are office-based treatments and often require more than one treatment session to see a significant improvement.
Each therapy has its own efficacy and side effect profile that should be carefully reviewed with your dermatologist. The associated costs should also be discussed as insurance companies usually regard liver spots as cosmetic problems that are not covered.
The best treatment, however, is often preventative. Wide-brimmed hats, clothing that covers your arms and legs and regular sunscreen are helpful for preventing liver spots, particularly during the peak sunlight hours of 10 a.m. to 4 p.m.
Q: Is there anything else that we need to know about liver spots?
While liver spots are harmless, they can be mistaken for a variety of other skin problems. Other skin entities that look like age spots range from simple moles to melanoma, a serious form of skin cancer that can be deadly.
Performing monthly self-exams and regular skin exams by your dermatologist are recommended to catch any suspicious spot before it becomes a problem. If you have a new spot, get it checked out. This is especially true if the spot is growing, changing color, has irregular borders, multiple colors or begins to itch or bleed.
Your dermatologist may ask about your sun exposure, family or personal history of skin cancer and then conduct a visual exam. In the uncommon situation where there is any doubt if a dark area is a liver spot, your dermatologist may order a biopsy for evaluation under a microscope. This is usually performed by your dermatologist in the office using a local anesthetic injected into the skin.
Notice some liver spots on your skin? Take Dr. Zaghi’s advice and find a dermatologist to learn more.
Learn more about Baylor Scott & White dermatology services here.