Sun Spots
Sun spots are flat brown patches that build up on the skin the sun reaches most, such as the face, the backs of the hands and the chest. They are harmless, but they are a record of past sun exposure.
Key facts
Sun Spots at a glance.
Typical signs
Flat brown patches
Common locations
Face, hands, chest, forearms
Expected course
Persist; new spots can appear
Treatment options
Pigment creams, peels or laser
What is it?
Top things to know about Sun Spots
- It is a flat area of pigment. A solar lentigo is a defined patch of increased pigmentation linked to ultraviolet exposure.
- It appears on sun-exposed skin. Spots often develop on the face, hands, forearms and shoulders.
- "Liver spot" is a misnomer. The common name does not mean the liver is involved.
- Diagnosis comes first. Atypical spots can resemble melanoma in situ, so uncertain lesions are examined before any cosmetic treatment.
What it looks like
What Sun Spots looks like
Sun spots are flat, tan to dark brown spots that appear on skin that has had years of sun exposure. They are usually oval or irregular, a few millimeters to over a centimeter wide, with a uniform color. They show up most on the face, backs of the hands, forearms, shoulders and upper back. Unlike freckles, they don't fade in winter. A spot that changes, darkens unevenly or has irregular edges should be checked.
Flat brown spots
Even tan to brown color.
Backs of the hands
One of the most common sites.
Shoulders
Clusters after years of sun.
Where it shows up
Solar lentigines commonly occur on sun-exposed areas such as the face, hands and forearms.
Face
Facial locations.
Arms
Locations along the forearms.
Hands and wrists
Hand, finger or wrist locations.
On different skin tones
Sun Spots on different skin tones
Sun spots are most common in lighter skin, where they look tan to brown against pale skin. They also occur in medium and darker skin, where they look darker brown and can be harder to tell apart from other dark patches such as melasma or post-inflammatory hyperpigmentation. In darker skin, harsh treatments can leave new dark marks, so lighter settings are often used.
What happens in Sun Spots?
Repeated ultraviolet exposure changes pigment activity in a small area of skin. Extra melanin produces a persistent flat brown spot, rather than a raised growth.
- Sun exposure leaves lasting changes: Repeated ultraviolet exposure affects pigment cells.
- More pigment gathers locally: Melanin increases in a small area.
- A flat brown spot appears: The patch stays level with surrounding skin.
Causes and triggers
What causes Sun Spots
Causes
Why it happens
Sun spots form when years of ultraviolet light make pigment cells produce extra melanin in one place. They build up slowly over decades.
Fair skin that burns easily and a family history of sun spots make them more likely.
Risk factors
Raise the odds
- Age over 40
- Fair skin
- Outdoor work or hobbies
- Tanning beds
Triggers
Bring it on or make it worse
- Unprotected sun exposure (Well established)
- Tanning beds (Well established)
- Sunburns (Strong link)
When it usually starts
When it usually starts
Sun Spots
Usually become more noticeable in adult life after cumulative sun exposure.
Daily care
Daily care for Sun Spots
Daily broad-spectrum sunscreen
SPF 30 or higher, hands and chest included, reapplied on days outside.
Shade, sleeves and a wide-brimmed hat
Add shade and protective clothing to your daily sun protection.
Have spots checked before treating them
Removing a spot that needed a biopsy is the one bad outcome here.
Ask about sun precautions for photosensitizing medicines; do not stop them yourself
Ask your prescriber rather than stopping anything yourself.
Avoid: Sun on unprotected skin
Daily incidental exposure adds up to more than holidays do.
Avoid: Tanning beds
A concentrated dose of the wavelengths that cause sun spots.
Avoid: Forgetting the hands, chest, ears and neck
Where the most noticeable spots turn up later.
Avoid: Sunscreen applied too thinly
Real-world protection is far below the number on the bottle.
Avoid: Window glass
Protect exposed skin near sunny windows; ordinary glass lets UVA through.
Avoid: Believing a base tan protects you
A tan is damage, and it protects very little.
Avoid: Picking or scratching a treated spot
A reliable way to swap it for a longer-lasting dark mark.
Avoid: Freezing kits sold for warts
Do not use wart-freezing kits on pigmented spots; they can scar unexamined skin.
Treatments
Treatments for Sun Spots
Retinol
Speeds up how quickly pigmented surface cells are shed, so spots lighten gradually from the top down. It is the over-the-counter option with the best evidence in sun spots, and it improves the surrounding sun-damaged skin at the same time. Start two or three nights a week to avoid irritation, and expect three to six months before the difference is obvious.
Glycolic Acid
Loosens the pigmented cells at the surface so they shed sooner, which lifts a little color out of a spot over months. It works better as the thing that helps a lightening cream get in than as a treatment on its own. Used too often it leaves skin irritated and more sun-sensitive, which on this page is exactly the wrong direction.
Cysteamine
Applied to dry skin, left for about fifteen minutes and washed off rather than left on overnight. It suits people who want a lightening step without hydroquinone, or something to hold a result between courses of it. Most of the trial evidence is in melasma rather than sun spots, and the smell is the usual reason people stop.
Alpha Arbutin
A gentler relative of hydroquinone that releases a small amount of it slowly in the skin. It is a reasonable long-term option on a spot you are lightening slowly, and it does not sting, which matters because irritation on a sun spot can leave a darker mark. The effect is mild and takes months.
Vitamin C
Lightens surface pigment modestly and adds a little to what sunscreen is doing during the day. It is easy to keep using for years, which is its real advantage here, since sun spots are a long game. On its own it will not clear an established spot.
Niacinamide
Slows the handover of pigment from pigment cells to the skin cells above them, so a spot fades a little rather than disappears. Its strength is that it is well tolerated and does not sting, so it sits comfortably alongside a retinol without making the skin sore. Modest on its own.
Kojic Acid
Blocks the same pigment-making enzyme hydroquinone does, more weakly. It is nearly always sold combined with other lightening ingredients, and the studies behind it are studies of those combinations. It stings some people, and irritation on a sun spot is not a neutral event, particularly on medium and deeper skin tones.
Hydroquinone 4%
The strongest cream for lightening a sun spot, applied thinly to the spot itself rather than the skin around it. It is used in a defined course of about three to four months with a break afterwards, not indefinitely, and it works best combined with a retinoid. It is slower than a single session of freezing or laser, and it is the option to prefer when treatment risk on deeper skin tones is the concern.
Tretinoin
The prescription retinoid, and the one with real trial evidence in sun spots specifically. It lightens spots over about six to ten months and improves the sun-damaged skin around them at the same time. Expect dryness and flaking early on, and use it at night with daily sunscreen, since it leaves skin more sun-sensitive. Ask your doctor about it if you are pregnant or trying to become pregnant.
Tazarotene
A stronger retinoid with good trial results in sun spots, used when tretinoin has not done enough. It works the same way, a little faster, and irritates more, so it is often started a few nights a week. Ask your doctor about it if you are pregnant or trying to become pregnant.
Cryotherapy
A few seconds of liquid nitrogen on each spot, done in the room, no anesthetic needed. The spot darkens, crusts and lifts off over one to two weeks. It suits a small number of spots rather than a whole hand, and its known cost is a permanent pale mark where too many pigment cells were destroyed, which is a bigger risk on medium and deeper skin tones.
IPL
IPL. The best option when there are many spots across a whole area such as the face, chest or the backs of the hands. Usually one to three sessions, with the spots darkening and flaking off over one to two weeks after each. It is aimed at contrast between spot and skin, so it works best on lighter tones and is used cautiously or not at all on deep skin.
Q-Switched Laser Tattoo Removal
The same pigment-shattering laser used for tattoo ink is used at low energy on individual sun spots, and it clears them reliably in one or two sessions. It is more precise than intense pulsed light and better for a few stubborn spots rather than a whole area. Settings have to be matched to the skin tone, since too much energy leaves a pale or a dark mark behind.
Picosecond Laser
Delivers its energy in much shorter pulses, which breaks up pigment with less heat spilling into the skin around it. That lower heat is the reason it is often chosen for medium and deeper skin tones, where a darker mark afterwards is the main worry. It costs more than the older lasers and the results in sun spots are broadly similar.
Chemical Peel
Lightens spots across a whole area rather than one at a time, which suits the backs of the hands, the forearms and the chest where spots are scattered widely. Usually a course rather than a single treatment, and the result is a general evening out rather than each spot disappearing. Depth matters: a peel strong enough to leave the skin raw can leave a darker mark instead.
Fraxel
Fraxel. Treats the sun-damaged skin as a whole rather than targeting individual spots, so it improves texture and fine lines alongside the pigment. That makes it a reasonable choice when the spots are only part of what is bothering you. For clearing spots alone it is slower, dearer and less precise than freezing or a pigment laser.
Microdermabrasion
Polishes off the very top layer of skin, which makes it briefly smoother and brighter. The pigment in a sun spot is held in ridges below that layer, so it is not reached. It is often sold as a treatment for spots and it is not one, and repeated sessions can irritate skin enough to leave marks of their own.
Outlook
What to expect with Sun Spots
Sun spots build up gradually and get noticed suddenly, usually in a photograph or bright bathroom lighting. They do not turn into skin cancer, but skin carrying a lot of them has had enough ultraviolet exposure that other changes are more likely, so watch for rough scaly patches and any spot behaving differently from its neighbors.
- 1
First spots · Thirties to forties
Most people see their first spots in their thirties or forties, earlier with heavy sun exposure or tanning beds.
- 2
Building up · The years after
They accumulate steadily over years rather than arriving in a batch.
- 3
Established · Any time of year
Individual spots do not go away on their own. Unlike a tan or a freckle they do not fade over winter, the most reliable way to tell them from freckles.
- 4
Merging · Later years
A spot may darken slightly over time, and clusters can merge into broader patches.
- 5
After treatment · If they are treated
A spot treated with freezing, laser or a peel usually clears and does not come back there. New spots keep appearing while sun exposure continues, so treating without changing sun habits means a new crop in a few years. Daily sun protection slows the rate.
Complications
Complications
- Associated concerns
Solar lentigines are benign, but they mark ultraviolet exposure and may coexist with other sun-damaged lesions. A changing or irregular spot needs assessment rather than an assumed age-spot diagnosis.
When to get help
When to get help
When to seek care
Have a new, changing, unevenly colored or bleeding spot checked before using a fading treatment.
Lookalikes
What else could it be?
Seborrheic Keratosis
Sun spots are flat and smooth. Seborrheic keratoses are more often raised, with a waxy or rough surface you can feel.
Actinic Keratosis
Sun spots feel smooth. Actinic keratoses feel gritty or scaly, sometimes before they are easy to see, and need assessment as precancerous patches.
Melanoma
Ordinary sun spots usually stay similar over time. A spot that changes, grows, has several colors or looks unlike the others needs checking for melanoma.
Questions
Questions you might be asking.
Are sun spots dangerous?
The spots are harmless and do not turn into cancer. What they indicate matters - that much sun exposure makes other changes more likely, so watch and protect those areas.
How do I tell a sun spot from something serious?
The reassuring pattern is flat, one even color, a clear edge, stable over time, similar to its neighbors. The pattern that needs a check is changing, growing, more than one color, a ragged or blurred edge, itching, bleeding, or a spot unlike the rest. Being unsure is a reason to have it looked at, not to worry.
What is the fastest way to get rid of them?
In-office treatment. Freezing works for a few spots; laser or intense pulsed light for many, usually over one to three sessions. Expect them to darken and flake off over one to two weeks. Creams work far more slowly.
Will they come back after treatment?
The individual spot usually does not return. New ones keep appearing on sun-exposed skin unless the sun protection changes, which is why people who treat spots and change nothing else are back within a few years.
Do sunscreen and creams help spots I already have?
Sunscreen does not remove them, but it stops them darkening and slows new ones. Retinoids, vitamin C, niacinamide and short courses of hydroquinone lighten existing spots over three to six months, more gently than a procedure.
I have deeper skin - is freezing a good option for me?
The one to be most cautious about. Freezing can destroy the pigment cells and leave a permanent pale mark, more noticeable on deeper skin tones and harder to correct than the original spot. Topical treatment first, conservative settings, a test spot, and a provider who treats deeper skin tones regularly is the safer path.
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