Visual inspection. Your doctor can usually diagnose age spots by looking at your skin. It is important to distinguish age spots from other skin conditions because the treatment is different and the wrong procedure can delay other necessary treatment.
Skin biopsy. Your doctor may do other tests, such as taking a small sample of skin for testing in the lab (skin biopsy). This can help distinguish age spots from other conditions, such as lentigo maligna, which is a type of skin cancer. A skin biopsy is usually performed in the doctor’s office under local anesthesia.
If you want to keep age spots noticeably smaller, they can be removed or removed. Pigment is located at the base of the epidermis, the topmost layer of the skin, so any treatment aimed at eradicating age spots must penetrate this layer of skin.
Age spot treatment includes:
Medicines. Using a bleaching cream (hydroquinone) alone or in combination with a retinoid (tretinoin) and a mild steroid can gradually fade spots over several months. Treatment may cause temporary itching, redness, burning, and dryness.
Lasers and intense pulsed light. Some lasers and intense pulsed light treatments kill the melanin-producing cells (melanocytes) without damaging the skin’s surface. These methods usually require two to three sessions. Ablative laser removes the top layer of skin (epidermis).
Freezing (cryotherapy). This procedure uses a cotton-tipped swab to apply liquid nitrogen for five seconds or less to treat the spot. It removes extra pigment. As the area heals, the skin will lighten. Spray freezing can be used on small groups of spots. The treatment causes temporary skin irritation and has a low risk of permanent scarring and discoloration.
Skin damage. Grind the surface layer of the skin with a fast rotating brush. New skin grows in its place. You may need to do the procedure more than once. Possible side effects include temporary redness, scaling, and swelling. It takes several months for the pink color to disappear.
Microdermabrasion. Microdermabrasion is a less invasive technique than dermabrasion. Leaves skin soft and smooth. To achieve modest and temporary results, you will need several procedures over several months. You may notice slight redness or tingling in the treated areas. If you have rosacea or small red veins on your face, this method can make the condition worse.
Chemical peel. This method involves applying a chemical solution to remove the top layer of skin. New, smooth skin is formed. Possible side effects include scarring, infection, and discoloration or darkening of the skin. Redness can last up to several weeks. It may take several treatments before you notice any results.
Age spot removal treatments are usually done in the doctor’s office and do not require a hospital stay. The duration of each procedure and the time to see results varies from weeks to months.
After treatment, use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30 and wear protective clothing when outdoors.
Age spot treatments are considered cosmetic and therefore not covered by insurance. The procedures can have side effects, so discuss your options carefully with a doctor who specializes in skin diseases (dermatologist). Also, make sure your dermatologist is specifically trained and experienced in the technique you’re considering.