Preventing and Treating Facial Skin Blotches

I'm 50 and don't spend a lot of time in the sun. I use sunscreen but I've noticed that I'm getting darker skin blotches, not like moles but damaged skin cells. My MD isn't worried, but I don't like the look. How do I get rid of them and protect my skin?

The most common skin blotches that appear after many years of sun exposure are called solar lentigos. These brown spots are smooth and do not have a rough texture. They are caused by years of unprotected sun exposure and are especially more common with lighter skin types.

Unlike freckles of childhood, these similar spots do not get better with age. Brown lentigos are benign and do not require treatment for medical reasons. Dermatologists offer a variety of treatments for them when a patient requests that something be done to reduce their appearance.

No treatment for the brown spots is perfect; however, treatment can improve their appearance. The most common treatment is freezing with light liquid nitrogen or the application of a bleaching cream that contains prescription strengths of hydroquinone. TCA medium depth chemical peels can remove a face full of lentigos. Laser treatment with a Yag laser or intense pulsed light may also offer significant improvement.

The only way to reduce future lentigos is strict sun avoidance or sun protection that utilizes the application of a sunscreen with an SPF rating or 30 or higher and broad spectrum protection against ultraviolet A.

Lentigos need to be differentiated from rougher seborrheic keratoses that are benign and inherited but will not respond to bleaching creams. Lentigos become medically significant if they show signs of turning black or significant growth which might indicate the development of lentigo maligna melanoma which is a dangerous form of skin cancer. Lentigos are also different than another condition of skin darkening called melisma, which is due to a combination of sun exposure, female hormones, pregnancy, or heredity.