Solar Lentigo

    Achieve Clearer Skin with Customised treatment for Solar Lentigo.

    The management of solar lentigines should be individualized, considering factors such as skin type, lesion characteristics, and patient preferences.

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    What is a solar lentigo?

    A solar lentigo (plural: solar lentigines), also known as a sunspot, or liver spot, is a harmless, hyperpigmented lesion surrounded by normal looking skin that results from chronic exposure to ultraviolet (UV) radiation. These spots are typically seen on sun-exposed areas of the skin, such as the face, hands, shoulders, and arms, and are more common in older adults above the ago of 50.

    What do solar lentigo look like?

    Clinical Presentation:

    • Size: Generally range from a few millimeters to several centimeters.
    • Shape: Round, oval, or irregular with well-defined borders.
    • Colour: Uniform pigmentation, ranging from light brown to black.
    • Location: Commonly appear on sun-exposed areas like the face, dorsal hands, forearms, upper chest, and back.

    How are solar lentigo diagnosed?

    Diagnosis is primarily clinical, based on the characteristic appearance and history of UV exposure. Under Wood’s light, solar lentigo appear darker.  Dermoscopy can be used to differentiate lentigines from malignant lesions such as melanoma. In rare cases, a biopsy may be performed to confirm the benign nature.

    Solar lentigo vs Melasma

    Solar lentigo and melasma are both common skin conditions characterized by hyperpigmentation, but they differ in appearance, causes, and treatment approaches. Here are the key differences:

    1. Appearance:

    • Solar Lentigo:

      • Typically appears as flat, brown or tan spots.
      • Often occurs on sun-exposed areas, such as the face, hands, and shoulders.
      • Usually well-defined and can vary in size.

    • Melasma:

      • Often presents as larger, irregular patches of brown or gray-brown pigmentation.
      • Commonly affects the cheeks, forehead, and upper lip.
      • Typically has a more diffuse, mottled appearance.

    2. Causes:

    • Solar Lentigo:

      • Primarily caused by chronic sun exposure, leading to localized skin damage.
      • More common in older adults due to cumulative UV exposure over time.

    • Melasma:

      • Often linked to hormonal changes (e.g., pregnancy, birth control pills).
      • Can also be triggered by sun exposure, but hormonal factors play a significant role.

    3. Demographics:

    • Solar Lentigo:

      • More prevalent in older adults and those with lighter skin types who have had significant sun exposure.

    • Melasma:

      • More common in women, especially during pregnancy (the “mask of pregnancy”) and in individuals with darker skin tones.

    4. Treatment:

    • Solar Lentigo:

      • Treatments include topical agents (hydroquinone, retinoids), cryotherapy, laser therapy, and chemical peels.
      • Focus is on reducing pigmentation and improving cosmetic appearance.

    • Melasma:

      • Treatment can be more challenging and often involves a combination of topical treatments (like hydroquinone and azelaic acid), sun protection, and sometimes lasers.
      • Management emphasizes prevention of triggers, particularly sun exposure.

    5. Prognosis:

    • Solar Lentigo:

      • Generally considered benign and may not require treatment unless for cosmetic reasons.

    • Melasma:

      • Can be more persistent and may recur even after successful treatment, particularly with continued sun exposure or hormonal changes.

    Solar Lentigo Treatments

    Treatment Options for Solar Lentigines:

    1. Topical Agents:

      • Hydroquinone: Considered the gold standard for depigmentation, hydroquinone works by inhibiting melanin production. It is typically used in concentrations of 2% to 4%, often combined with retinoids or corticosteroids for enhanced efficacy.
      • Retinoids (e.g., Tretinoin): Retinoids accelerate skin cell turnover and reduce the appearance of hyperpigmentation. They are frequently used in combination with hydroquinone for optimal results.
      • Cysteamine: A study demonstrated that Cysteamine, a depigmenting and anti-oxidant agent significantly lightened solar lentigo after 12 weeks of application.
      • Other Lightening Agents: Azelaic acid, kojic acid, and niacinamide are also effective in reducing hyperpigmentation by targeting melanin synthesis.

    2. Chemical Peels:

      • Superficial Chemical Peels: Agents like glycolic acid, salicylic acid, or trichloroacetic acid (TCA) are used to exfoliate the skin and promote the regeneration of new, evenly pigmented cells.
      • Medium-Depth Peels: TCA in higher concentrations can penetrate deeper, offering more significant improvement but requiring longer recovery periods.

    3. Cryotherapy:

      • Liquid Nitrogen Treatment: A quick and effective method where liquid nitrogen is applied to the lesion to induce freezing and destruction of excess melanocytes. This method is suitable for isolated lesions but may cause temporary hypopigmentation or scarring in darker skin types.

    4. Laser and Light-Based Therapies:

      • Picosecond Laser: These laser use ultrashort pulses to break down pigmentation with minimal collateral skin damage.
      • Q-Switched Lasers: These lasers target melanin within the skin with minimal damage to surrounding tissue, making them highly effective for solar lentigines. Common types include Q-switched Nd
        and Q-switched ruby lasers.
      • Intense Pulsed Light (IPL): IPL therapy uses broad-spectrum light to target pigmented lesions. It is particularly effective for patients with lighter skin tones and minimal downtime is required.
      • Fractional Lasers: These lasers create micro-injuries in the skin to stimulate the body’s natural healing process and improve pigmentation.

    Solar lentigo insight

    Patient education is crucial, as individuals should be informed about the benign nature of solar lentigines and the importance of sun protection to prevent recurrence. Ongoing research into novel treatments, including combination therapies and advanced laser technologies, holds promise for enhancing outcomes.

    Dr. Moses Ng

    Schedule a consultation for Solar lentigo removal in Singapore

    Solar lentigines, commonly known as age spots or liver spots, are benign skin lesions resulting from prolonged UV exposure. As the prevalence of these lesions increases with age, particularly among populations with significant sun exposure, effective treatment options have become a focus in dermatology.

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    References:
    1. Scarcella G, Dethlefsen MW, Nielsen MC. Treatment of solar lentigines using a combination of picosecond laser and biophotonic treatment. Clinical Case Reports. 2018 Sep;6(9):1868.
    2. Schoenewolf NL, Hafner J, Dummer R, Bogdan Allemann I. Laser treatment of solar lentigines on dorsum of hands: QS Ruby laser versus ablative CO 2 fractional laser–a randomized controlled trial. European Journal of Dermatology. 2015 Apr;25:122-6.

    ABOUT DR MOSES NG

    Dr Moses Ng dermatologist

    MBBS (London) with distinction
    Dip Practical Dermatology (Cardiff) with distinction
    Member of American Acne & Rosacea Society
    Fellow of American Society for Laser Medicine & Surgery

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    Dr. Moses Ng is a distinguished professional in the field of aesthetic medicine, renowned for his expertise in advanced cosmetic procedures. With over 15 years of experience, extensive training and a keen eye for detail, Dr. Ng specializes in a wide range of treatments, including injectables, laser therapies, and acne scar management.

    Dr. Moses Ng’s commitment to excellence and patient-centric approach have earned him a reputation as a trusted clinician in aesthetic medicine. His continuous pursuit of the latest advancements in the field ensures that his patients receive the highest standard of care and the most effective treatments available.

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