Solar lentigines are flat, brown spots on the skin caused by years of sun exposure. Often called “age spots” or “liver spots,” they are harmless accumulations of pigment in the outer layer of skin. They affect over 90% of fair-skinned individuals by age 60, making them one of the most common visible signs of sun damage.
What Solar Lentigines Look Like
Solar lentigines range from a few millimeters to several centimeters across. They appear as flat or very slightly raised spots with a well-defined edge, sometimes described as having a “moth-eaten” border on the trunk and limbs. Color ranges from yellow-tan to dark brown or black, though each individual spot is usually uniform in color. They can be round, oval, or irregular in shape.
The most common locations are areas that get the most cumulative sun: the backs of the hands, the forearms, the face, the chest, and the shoulders. A single person may have a handful or dozens, and they tend to multiply with age. Unlike freckles, which often fade in winter, solar lentigines persist year-round once they form.
How UV Damage Creates Them
Prolonged UV exposure drives structural changes in the skin over time, a process known as photoaging. One of those changes is abnormal pigment production. UV radiation damages DNA in pigment-producing cells (melanocytes), triggers oxidative stress, and alters the signaling chemicals that control how much pigment those cells make. Over years, specific clusters of melanocytes ramp up melanin production and deposit it in the surrounding skin cells, creating a visible spot.
This is a cumulative process. A single bad sunburn won’t produce a solar lentigo the next week, but decades of sun exposure gradually push melanocytes toward this overproduction. That’s why the spots become more numerous and prominent as people age.
Who Gets Them
Almost anyone with significant lifetime sun exposure can develop solar lentigines, but some groups are more prone. Fair-skinned people develop them earlier and in greater numbers, which is why the 90%-by-age-60 statistic applies specifically to lighter skin types. However, people with medium and darker skin tones are far from immune. Research on a coastal population in Jakarta found that people with olive to medium-brown skin actually showed higher overall photoaging scores than those with lighter skin, likely because their melanocytes are more reactive to UV stimulation. In darker skin, photoaging tends to show up as pigmentation changes first, rather than wrinkles.
Other factors that increase your likelihood: male sex, a history of frequent sunburns, active smoking, and older age. Tanning bed use counts the same as natural sun exposure.
Are They a Sign of Something Serious?
Solar lentigines themselves are benign. They don’t become cancerous. But their presence tells you something important: your skin has absorbed a significant amount of UV damage. That same damage raises your risk for skin cancer independently.
One study found that having many solar lentigines on the trunk was associated with a greater than threefold increased risk of basal cell carcinoma in the same area, compared to roughly a 50% increased risk for spots on the head. The lentigines aren’t causing the cancer. They’re a visible marker of the same UV damage that does.
When a Spot Needs Closer Evaluation
The main concern with any brown spot is making sure it isn’t melanoma or its precursor, lentigo maligna. A typical solar lentigo is uniform in color and has a clearly defined border. Features that raise suspicion include color that varies within a single spot (mixing light and dark brown, or adding shades of gray or blue), borders that are blurred or irregular in a way that differs from the usual moth-eaten pattern, and a spot that is changing in size, shape, or color over weeks to months.
Dermatologists use a magnifying tool called a dermatoscope to examine suspicious spots more closely. Specific patterns, such as pigment filling in the openings around hair follicles or a diamond-shaped grid pattern in the pigment, can suggest lentigo maligna rather than a harmless sun spot. If those features are present, a small skin biopsy confirms the diagnosis. The takeaway: any new or changing dark spot, especially on sun-exposed skin, is worth having examined.
Treatment Options
Because solar lentigines are cosmetic rather than medical, treatment is entirely optional. But several approaches work well for people who want to lighten or remove them.
Topical Treatments
Prescription creams containing a bleaching agent and a retinoid can gradually fade solar lentigines over several months. A solution combining a pigment-lightening compound with a low-concentration retinoid, applied twice daily, showed significant lightening after two months in clinical testing, and the improvement lasted at least two months after stopping treatment. Triple-combination creams that add a mild anti-inflammatory to the mix have also been used effectively, sometimes alongside other procedures.
These creams require patience. Visible results typically take two to three months of consistent daily use. They work best on lighter spots and may not fully eliminate darker or larger lentigines.
In-Office Procedures
Cryotherapy (freezing with liquid nitrogen) is one of the quickest options. A brief application destroys the pigmented cells, and the spot peels away over a week or two. It works well for individual spots but can occasionally leave a lighter or darker mark, especially on darker skin tones.
Laser treatments target the pigment directly and tend to offer the most complete removal with fewer pigmentation side effects. Chemical peels and intense pulsed light therapy are also used, particularly when someone wants to treat a broader area like the entire face or backs of both hands rather than individual spots.
Prevention
New solar lentigines will continue forming as long as your skin keeps accumulating UV damage. The most effective prevention is consistent sun protection: broad-spectrum sunscreen of at least SPF 30 applied daily (even on overcast days or when you’ll be mostly indoors, since UV penetrates windows), sun-protective clothing, and limiting time in direct midday sun. Starting sun protection early in childhood makes a meaningful difference, since much of the UV damage that eventually produces solar lentigines accumulates in the first few decades of life.
For spots that have already been treated, sun protection is also what keeps them from coming back. Without it, treated areas are likely to re-pigment within a few years.