Skip to main content

Health condition · Clinically reviewed

Age spots, confirm the diagnosis, then treat with the right tool.

Also called solar lentigines or liver spots. Benign, common - and highly treatable once melanoma has been excluded. Prevention with daily SPF is the single biggest lever.

Jump to treatment
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BAD and peer-reviewed dermatology sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK guidance including topical lightening agents, cryotherapy, IPL and pigment-targeted lasers.

Key facts

Age spots at a glance.

The essentials in plain English - what they are, what they are not, and how they are treated in the UK today.

  • What they are

    Solar lentigines (also called liver spots) are flat, well-defined brown patches caused by chronic UV-driven melanocyte proliferation and increased melanin.

  • Where they appear

    On sun-exposed skin: face, backs of hands, forearms, shoulders, upper back and décolletage.

  • Not the same as

    Distinct from freckles (ephelides, inherited, fade in winter), seborrhoeic keratoses (raised, scaly), melasma (hormonal patches) and, crucially, melanoma.

  • Prevention first

    Daily broad-spectrum SPF 30-50, sun-protective clothing and avoiding tanning are the single biggest levers.

  • In-clinic treatment

    Cryotherapy, chemical peels, IPL and pigment-targeted lasers (Q-switched Nd:YAG, ruby, Fraxel 1927 nm) all work well when the diagnosis is confirmed.

  • Skin of colour

    Fitzpatrick IV-VI skin is at higher risk of post-inflammatory hyperpigmentation, so gentler settings and longer courses are usually safer.

Why this guide matters

Rule out cancer first. Treat second.

Most age spots are entirely benign, but they share a stage with lesions that are not. The three points below shape everything else on this page.

  • Always exclude melanoma

    Any lesion that is asymmetric, has an irregular border, contains several colours, is over 6 mm or is changing needs a specialist opinion and biopsy.

  • Prevention is the biggest lever

    Daily broad-spectrum SPF 30-50, sun-protective clothing and no deliberate tanning stops most new lentigines forming and keeps treated skin clear.

  • Match the treatment to the lesion

    A few scattered spots suit cryotherapy or Q-switched laser. Diffuse pigmentation across the face usually responds better to IPL or Fraxel 1927 nm.

How the diagnosis is made

From a first look to a clear plan.

The steps a UK GP or dermatologist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Full-skin history and exam

    A structured look at every pigmented lesion, not just the ones that bother you, with attention to sun-exposure history and skin type.

  2. 02

    Assessing

    ABCDE screen

    Asymmetry, Border irregularity, Colour variation, Diameter over 6 mm and Evolving change are checked on every lesion to rule out melanoma.

  3. 03

    Assessing

    Distinguish from mimics

    Freckles fade with less sun, seborrhoeic keratoses feel waxy and raised, melasma sits in symmetrical hormonal patches. Each is treated differently.

  4. 04

    Confirming

    Dermatoscopy

    A handheld dermatoscope shows the pigment network. A parallel, smooth, evenly pigmented network favours a benign lentigo.

  5. 05

    Confirming

    Biopsy any concerning lesion

    Anything asymmetric, irregularly bordered, multi-coloured, larger than 6 mm or changing gets a skin biopsy - never assume it is just a spot.

  6. 06

    Preparing

    Full-body skin cancer check

    Age spots often bring people in for the first time. A one-off full-body screen picks up unrelated basal cell and melanoma lesions early.

  7. 07

    Preparing

    Treatment planning

    Skin type, lesion count, distribution and downtime tolerance shape the plan - topical, cryotherapy, chemical peel, IPL or laser.

Typical timeline: a first visit to a settled plan in a single appointment for straightforward cases.

Symptoms

What age spots actually look like.

The classic pattern of flat, evenly pigmented brown patches on sun-exposed skin - and the features that mean it is time for a specialist opinion.

  • Flat brown macules

    Well-defined, tan-to-dark-brown flat patches on sun-exposed skin - the classic lentigo.

  • Symmetrical, round or oval

    Benign lentigines are usually regular in shape with an even colour throughout.

  • Multiple lesions in a UV pattern

    Grouped over cheeks, temples, hand backs, forearms, shoulders and décolletage - a map of past sun exposure.

  • Stable over months

    True age spots grow slowly if at all. Rapid change deserves a specialist opinion.

  • Post-inflammatory pigmentation

    Old acne, eczema or laser treatment can leave brown marks - often mistaken for lentigines but managed differently.

  • Melasma patches

    Symmetrical brown patches on forehead, cheeks and upper lip, hormonally driven - not the same as age spots.

  • Seborrhoeic keratoses

    Raised, waxy, stuck-on-looking growths - benign, but easily confused with lentigines to the naked eye.

  • Red flag - ABCDE features

    Asymmetry, irregular border, colour variation, diameter over 6 mm or evolving change - biopsy to exclude melanoma.

Treatment

How age spots are treated in the UK.

Prevention first, then topicals for maintenance, and in-clinic treatments - cryotherapy, chemical peels, IPL or pigment-targeted lasers - for visible lesions.

  • Daily broad-spectrum SPF

    SPF 30-50 every morning, reapplied through the day - the most effective single intervention for preventing new spots and stopping treated ones returning.

  • Topical retinoid (tretinoin)

    Nightly tretinoin speeds pigment turnover and fades lentigines over 3-6 months. Introduce slowly to reduce irritation.

  • Hydroquinone 2-4%

    Prescription lightening agent, usually 8-12 week courses to avoid ochronosis. Often combined with a retinoid and mild steroid (Kligman formula).

  • Azelaic acid, kojic acid, niacinamide, vitamin C

    Gentler pigment inhibitors used alone or stacked - safer options in pregnancy and in Fitzpatrick IV-VI skin.

  • Oral or topical tranexamic acid

    Reduces melanocyte activity - increasingly used for stubborn facial pigmentation, under specialist supervision when taken orally.

  • Cryotherapy

    Liquid nitrogen freezes individual spots in seconds. Quick and effective for scattered lesions but carries a real risk of hypopigmentation, especially in darker skin.

  • Chemical peel

    Superficial to medium-depth TCA or glycolic peels resurface pigmented skin. A short course spaced weeks apart usually gives the best result.

  • IPL photofacial

    Intense pulsed light targets brown pigment across a whole area - excellent for face, hands and chest in lighter skin types.

  • Q-switched Nd:YAG or ruby laser

    Pigment-specific nanosecond lasers shatter melanin in individual spots. Precise, well-evidenced, minimal downtime.

  • Fraxel 1927 nm thulium laser

    The gold-standard fractional laser for pigmentation - clears diffuse sun damage across the face in 2-4 sessions with mild peeling.

  • Fractional resurfacing

    For patients with combined pigmentation, texture and fine-line concerns - one treatment addresses several problems at once.

  • Kligman formula

    Prescription triple combination of hydroquinone, retinoid and mild steroid - used short-term for stubborn facial pigmentation under dermatology supervision.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, specialist society standards and consensus dermatology literature, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or dermatologist knows your skin and history and can tell you which parts apply to you. If in doubt, get seen.

  • British Association of Dermatologists (BAD). Patient information leaflets on lentigines, melasma and skin cancer.

  • NICE. Suspected cancer: recognition and referral (NG12) - melanoma criteria.

  • Primary Care Dermatology Society. Solar lentigo and seborrhoeic keratosis guidance.

  • European Academy of Dermatology and Venereology. Consensus statements on pigmentation disorders and laser therapy.

Red flags

When a pigmented lesion needs urgent attention.

Most age spots are entirely benign. These are the features that are not - and where a specialist opinion, or a biopsy, is needed.

  • ABCDE features

    Asymmetry, irregular Border, Colour variation, Diameter over 6 mm or an Evolving lesion - urgent dermatology referral and biopsy.

  • A new lesion in an older adult

    Any new or rapidly changing pigmented lesion after 50 deserves a low threshold for specialist review.

  • Bleeding, crusting or ulceration

    True age spots do not bleed or ulcerate. If they do, think melanoma or non-melanoma skin cancer.

  • Lentigo maligna suspicion

    A slowly enlarging, irregularly pigmented patch on the face in older skin can be lentigo maligna - a melanoma-in-situ needing urgent biopsy.

  • Very dark or multi-coloured pigment

    Black, blue or several shades within one lesion are a red flag - not a normal feature of a benign lentigo.

  • A "spot" that itches, stings or hurts

    Persistent symptoms in a pigmented lesion warrant an in-person review.

  • Immunosuppression

    Transplant recipients and other immunosuppressed patients need a lower threshold for skin cancer screening.

  • Personal or family history of melanoma

    Regular full-skin checks matter - and any new pigmented lesion should be assessed sooner rather than later.

  • Post-treatment pigmentation change

    New hyperpigmentation or persistent white patches after laser, IPL or cryotherapy need a clinician review to guide next steps.

Living with it

A treatable condition, with a clear ladder.

Four things that make the biggest difference - daily sun protection, patience with topicals, matching the right in-clinic tool to the lesion, and never treating an unconfirmed pigmented spot.

A quiet reminder

Sunscreen is the treatment that keeps working.

Every laser and every lightening cream loses ground without daily broad-spectrum SPF. Get that right and the rest becomes much easier.

  1. 01 Prevention

    Daily SPF, every day

    Broad-spectrum SPF 30-50 every morning and reapplied through the day is the single best habit for stopping new spots and keeping treated skin clear.

  2. 02 Patience

    Give topicals 3 to 6 months

    Retinoids and lightening agents work slowly. Judge results at three months, not three weeks - and keep going.

  3. 03 Escalate

    Match the tool to the lesion

    A few scattered spots respond well to cryotherapy or Q-switched laser. Diffuse sun damage often needs IPL or Fraxel.

  4. 04 Confirm

    Never treat an unconfirmed lesion

    If any lesion looks atypical, biopsy first, treat second. Lasering a melanoma delays diagnosis and worsens outcomes.

Frequently asked

Everything we get asked about age spots.

Quick answers on distinguishing age spots from melanoma, choosing between IPL and laser, and treating skin of colour safely.

  • What are age spots?

    Solar lentigines - also called liver spots - are flat brown patches on sun-exposed skin caused by chronic UV exposure driving melanocyte proliferation and increased melanin. They are benign but reflect a lifetime of sun damage, so a skin cancer check at the same visit is always sensible.

  • How are age spots different from freckles or melasma?

    Freckles (ephelides) are inherited, appear in childhood and fade in winter. Melasma is hormonal, sits in symmetrical patches on the face and often follows pregnancy or the contraceptive pill. Age spots are UV-driven, do not fade with less sun and tend to appear from the 40s onwards.

  • Could an age spot be skin cancer?

    Most are entirely benign. But any lesion that is asymmetric, has an irregular border, contains several colours, is larger than 6 mm or is evolving needs a dermatologist review and a biopsy. Lentigo maligna in particular can look like a slow-growing age spot on the face.

  • What is the best treatment for age spots?

    It depends on how many and where. A few scattered lesions respond quickly to cryotherapy or a Q-switched laser. Diffuse pigmentation across the face is usually better treated with IPL or the Fraxel 1927 nm laser. Topical hydroquinone, retinoids and antioxidants help maintain results.

  • Are age spot treatments safe on darker skin?

    They can be, but Fitzpatrick IV-VI skin has a higher risk of post-inflammatory hyperpigmentation with aggressive treatment. Gentler options - azelaic acid, tranexamic acid, careful IPL settings, longer laser intervals - are usually the safer choice. A clinician experienced in skin of colour is important.

  • Will age spots come back after treatment?

    They can, especially without daily sun protection. Once you clear an area, the melanocytes are still primed to make pigment. Daily broad-spectrum SPF, sun-protective clothing and avoiding deliberate tanning are essential to keep skin clear.

Related content

Keep reading.

Pulse Healthcare concierge

Send us your enquiry

A concierge service for UK private healthcare. We match you with the best vetted clinics and consultants in our network - they then contact you directly.

So we can match you to the right clinician close to you.

We reply to every enquiry within 24 hours (Mon–Fri). Confidential - your details are never shared outside our vetted consultant network.