The Caring Corner®
The Usual Suspects: Common Skin Spots in Aging Adults
When we talk about skin spots in older adults, a few types tend to dominate the conversation:
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Solar Lentigines (Age Spots/Liver Spots): These are arguably the most common and recognizable. Appearing as flat, brown or black spots, solar lentigines are primarily caused by years of sun exposure. They are most prevalent on areas frequently exposed to the sun, such as the face, hands, arms, and shoulders. Despite their common name “liver spots,” they have no relation to liver function. They are essentially areas where melanin, the pigment that gives our skin color, has accumulated due to UV damage. While generally benign, their presence indicates significant sun exposure, which is a risk factor for skin cancer.
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Seborrheic Keratoses: These are often described as “stuck-on” or “warty” growths. They can vary in color from light tan to dark brown or black and can be flat or raised. Seborrheic keratoses are incredibly common in aging adults and are considered benign, though they can sometimes be itchy or irritated, especially if they are in an area of friction. Their cause isn’t fully understood, but genetics and sun exposure are thought to play a role. They can appear almost anywhere on the body, including the face, scalp, chest, and back.
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Cherry Angiomas: These bright red, small, dome-shaped bumps are made up of tiny blood vessels. They are extremely common, with most adults developing several over their lifetime. Cherry angiomas are harmless and typically don’t require treatment unless they are bothersome cosmetically or bleed due to trauma. The exact cause is unknown, but genetics seem to play a role, and they tend to increase in number with age.
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Actinic Keratoses (AKs): These are different from the spots mentioned above because they are considered precancerous. Actinic keratoses are rough, scaly patches that can be skin-colored, pink, red, or brown. They often feel like sandpaper to the touch and develop on sun-exposed areas like the face, scalp, ears, and hands. While most AKs do not turn into skin cancer, a small percentage can evolve into squamous cell carcinoma, a type of skin cancer. Therefore, it’s crucial to have any suspicious rough patches evaluated by a dermatologist.
Why Do They Appear? The Science of Skin Aging
- Sun Exposure (UV Radiation): This is by far the most significant culprit, especially for solar lentigines and actinic keratoses. UV radiation damages DNA in skin cells, leading to abnormal melanin production and cellular changes.
- Genetics: Our genetic predisposition plays a role in how our skin ages and how susceptible we are to developing certain types of spots.
- Cumulative Damage: Years of exposure to environmental factors, pollution, and even lifestyle choices contribute to the overall aging process of the skin.
- Decreased Cell Turnover: As we age, the rate at which our skin cells regenerate slows down, leading to a buildup of damaged cells and pigment.
- Fragile Blood Vessels: The structural integrity of blood vessels can weaken with age, leading to conditions like cherry angiomas or increased susceptibility to bruising.
Prevention and Management: Protecting Your Skin
- Sun protection is paramount
- Wear broad-spectrum sunscreen with an SPF of 30 or higher daily, even on cloudy days.
- Seek shade, especially during peak sun hours (10 AM to 4 PM).
- Wear protective clothing, wide-brimmed hats, and UV-blocking sunglasses.
- Regular skin self-exams
- Annual dermatological check-ups
