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Liver spots

Definition

Liver spots are flat, brown-black spots that usually appear on the skin in sun-exposed areas of the body. They have nothing to do with the liver or liver function.

Alternative Names

Sun-induced skin changes - liver spots; Senile or solar lentigines; Skin spots - aging; Age spots

Causes, incidence, and risk factors

Liver spots are changes in skin color that occur in older skin. The increased color may be due to aging, exposure to the sun or other forms of ultraviolet light, or other unknown causes.

Liver spots are very common after age 40. They occur most often on areas that have had the greatest sun exposure, such as the:

• Backs of the hands
• Face
• Forearms
• Forehead
• Shoulders

Symptoms

Skin lesion that is:

• A flat patch or area of skin color change (macule)
• Light brown to black
• On the hands, arms, or forehead
• Painless

Signs and tests

A diagnosis is based on the appearance of the skin, especially if you are over 40 and have had a lot of sun exposure over the years. A liver spot that looks irregular may be biopsied to confirm that it is not skin cancer.

Treatment

No treatment is needed in most cases. You can improve the appearance of your skin by using skin bleaching lotions or creams. Most bleaching lotions use hydroquinone. This can cause blisters or skin reactions in some people. See your health care provider before starting treatment if you are worried.

Freezing (cryotherapy) or laser treatment can be used to destroy the liver spots.

Support Groups

Expectations (prognosis)

Liver spots are not medically dangerous. They are permanent skin changes that may affect the cosmetic appearance of the skin.

Complications

Liver spots are harmless and painless, but they may affect the appearance. This can cause emotional distress.

Occasionally, liver spots may make it difficult to diagnose skin cancers.

Calling your health care provider

Call for an appointment with your health care provider if:

• You have liver spots and want them removed
• You develop any new symptoms, especially changes in the appearance of any liver spot

Prevention

Protect your skin from the sun by taking the following precautions:

• Wear protective clothing such as hats, long-sleeved shirts, long skirts, or pants.
• Use sunglasses to protect your eyes.
• Try to avoid sun exposure at midday, when sunlight is most intense.
• Use high-quality sunscreens, preferably with sun protection factor (SPF) ratings of at least 30. Apply sunscreen at least a half hour before exposure, and reapply often. Use sunscreen in the winter, too.

References

Habif TM. Light-related diseases and disorders of pigmentation. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 19.