Age Spot Treatments

Microdermabrasion can diminish the appearance of age spots however results are temporary. Better solutions include-

• Chemical peels such as Cosmelan or Vi Precision Plus.
• Lasers such as Pico or fractional laser resurfacing.

Whilst hydroquinone can diminish the appearance of age spots, this ingredient can not be used long term due to side effects such as paradoxical darkening or rebound. HQ is best for melasma & post inflammatory hyperpigmentation. 

22% hydroquinone can potentially offer a superficial peel to abort early age spots. Be guided by your dermatologist. 

DPN or Morgan Freeman disease (a form of age spots) are frequently seen in darker skin types. They are a special form of age spot called seborrheic keratosis or age warts. They range in size from 1 mm to 3.5 mm & frequently affect the face, neck & chest area. Often DPN are seen in families, & they increase in size & number with age. Dermatosis papulosa nigra lesions are harmless, however they are often unsightly. 

Our dermatologist removes these lesions with curette surgery, pin-point hyfrecation, or with lasers. One session will safely & effectively remove 80-90% of lesions. 

DPN removal at The Melasma Clinic

• Takes 30 minutes
• Is painless
• Skin heals within 5 days without scarring
• Cost between $2590 to $3590 per session
• Is performed by our dermatologist

Pigmentation is complex, with over 150 different types. Even within the category of age spots, there are various pigmentation disorders. For instance, both lentigo and macular seborrheic keratosis are considered age spots, but they require vastly different treatments.

Lentigo age spots can be treated effectively with BBL Hero, IPL, high pass Fraxel, or simple Pico/nano lasers. In contrast, thicker macular seborrheic keratosis often requires specialized lasers and techniques.

Additionally, there are other types of pigmentation such as melasma, Hori’s nevus, mixed dermal pigmentation, moles, ephelides (freckles), and pigmented solar keratosis, each needing specific treatments. In many cases, age spots occur with other pigmented lesions. 

Australia has the highest rate of melanoma in the world, so it is crucial to diagnose a pigmented age spot accurately before undergoing laser treatment. If unsure, consult a dermatologist for a thorough skin check.

Finally, skin type matters. Treatment for fair skin differs significantly from that for darker skin. For darker skin, pre- and post-treatment creams are used, and pico lasers are preferred.

It is unlikely that age spots will become cancerous, however between 2-5% of raised age spots or seborrheic keratosis may develop a superficial form of skin cancer known as in IEC or intraepithelial carcinoma. This is known as a collision tumor. Your dermatologist can identify these lesions & manage appropriately.

In exceptional cases melanomas can arise next to, or within seborrhoeic keratosis.  

Melanomas may look like age spots. Conversely age spots may resemble melanomas. A dermatologist can tell the difference between these lesions with close dermatoscopic examination. A skin biopsy may be required in some cases. 

Melanomas: may have irregular borders & many colors. They grow faster than the average age spot. Age spots are more homogenous in color with more regular borders.

The 2 most common causes of pigmentation worsening are; post inflammatory hyperpigmentation & the wrong diagnosis. 

1. Post inflammatory hyperpigmentation. This can be due to –
   • Wrong laser used. 
   • Wrong settings used. 
   • Patient factors. The most common, sun exposure.
2. Wrong diagnosis. It’s complex, but age spots can look like lichenoid keratosis, melanoma in situ or melanomas. 

*IF your pigmentation has worsened, speak to your clinician. If they use a laser for pigment treatments, they should at least be able to diagnose the spot & treat any potential side effects, including post-laser darkening. 

The best way to naturally treat age spots is with frozen nitrogen (nitrogen is natural as it constitutes 78% of the atmosphere). Freeze this gas, then apply to the age spot in question. Your GP or dermatologist can guide you through the process of cryotherapy. 

At the Melasma Clinic we use light to treat age spots. We concentrate the beams of light to give laser light. Other naturally derived topicals that can be effective include-

• Ascorbic acid: vitamin C
• Azelaic acid: derived from wheat
• Glycolic acid: found in sugar cane

*Warning: Do not use lemon juice or apple cider vinegar to treat age spots. These home remedies may cause burns. Our clinicians are not naturopathatic practitioners, we prescribe lasers & chemicals based upon scientific research, not Reddit forums. 

Nitrogen or freezing is an effective way to treat age spots in lighter skin types. This is a cost effective way of removing most forms of pigmentation including age spots, pigmented sun spots, freckles & flat age warts or seborrheic keratosis. 1-3 sessions are required for best results. A skin cancer ‘specialist’ can provide this treatment. 

*Our clinicians employ lasers over liquid nitrogen freezing as lasers are more accurate, have less side effects & a faster healing time. The downside about laser therapy is the costs. 

Fraxel is an excellent laser for skin rejuvenation as it can treat age spots, sun spots, freckles, melasma & post inflammatory hyperpigmentation. Using special ‘hyper-dense’ settings Fraxel can markedly reduce age spots in one or two sessions. 

QSL or pico lasers however, are better treatment options for individual age spots. They offer faster & better clearances for individual spots, as compared to fractional laser resurfacing.