Identifying Age Spots and Sun Spots

As time goes on, we start to notice brown spots and freckles — “souvenirs of Florida” — on the backs of our hands and on other sun exposed areas like the upper chest and face. At first these brown spots are small and light colored, but eventually they become a cosmetic problem — an obvious sign of premature aging of the skin because of ultraviolet damage from sun exposure or from tanning beds.

By using modern high-SPF sunscreens like Ombrelle-60™ or Anthelios-60™ we can safely enjoy outdoor activities like gardening, golf and boating, and greatly reduce the rate at which our skin deteriorates. Patients who get into the habit of applying Retisol-A 0.01% cream (a prescription product which combines a retinoid and an SPF-15 sunscreen) to their faces every morning will usually see a considerable improvement in the appearance of their skin after 1-2 years, and if treatment is continued long-term patients will notice that their skin ages more slowly.

Hats and sun protective clothing can also slow down the rate at which “age spots” appear – and also reduce the chance that we will develop skin cancer. You can learn more about how to prevent sun damage, learn about the early warning signs of skin cancer and see photos of typical skin cancers at Skin Cancer Guide.ca.

The early warning signs of skin cancer include:

* new and unusual growths on the skin
* moles and freckles which have unusual colors or mixtures of colors
* moles and freckles with irregular borders
* growths on the skin which bleed, or which form an open sore which does not heal within a few weeks.

It is not too late for those of us who already have sun spots and age spots. I have seen many patients who had sun damage improve gradually over a period of 3-5 years simply in response to daily sun protection. For those who want more rapid and complete improvement in their sun damaged skin, one or two treatments with the Medlite™ laser can fade or eliminate brown “age spots” on the face, chest and hands within a few weeks.

Intense Pulsed Light (IPL) treatments, for example with the Cutera Xeo-600, can be used in cases where there is a background of tiny freckles and brown discoloration – sometimes erasing 20 years of irregular pigment with a series of 20 minute treatments! Where there is severe sun damage or when a person wishes the most rapid improvement (for example, if a daughter is getting married in two months) a medicine called Levulan™ is applied to the skin for one hour before treatment with the Cutera Xeo-600. Levulan™ is absorbed by cells in the skin which are misbehaving, and then is activated by light from the Xeo-600. The abnormal cells are shed from the skin over a period of 1-2 weeks, revealing fresher, healthier skin – and giving the patient a “fresh start”. What ever the type of spot – if you have concerns, or if you see changes in its appearance, it is important that you have it inspected by your family physician or dermatologist.

Self-Examination For Skin Cancer

Most people have freckles, birthmarks, or moles, but any irregularities or a change in the shape, edge, colour or size can be warning signs of skin cancer.

Skin cancer can take 20 years or more to develop. Many forms grow slowly, but some melanomas may grow quickly. If found in the early stages it’s very treatable, and the way to find it early is by doing a self-exam every three to six months. This should take no more than 5 or 10 minutes, 10 minutes that could save your life. You can also view a brief video on early detection at Skin Cancer Self-Examination.

Self-Examination: Where to look

1. Examine your head and face using one or two mirrors. Moving your hair aside, to examine your scalp.
2. Examine your hands, including your nails.
3. Check your elbows, arms and underarms.
4. Look closely on your neck, chest and torso – check under your breasts if you are a woman.
5. Using a second mirror examine the back of your neck and shoulders, as well as your upper arms, legs, back, and behind.
6. Sit down and examine your lower legs and feet, including nails, heels, and soles.
7. Use a small mirror to check your genitals.

Self-Examination: What to look for

• Note changes on your skin, such as a growth or a sore that won’t heal
• Look for small lumps that are smooth, shiny and waxy, or red or reddish brown
• Be alert to flat red spots that are rough or scaly

For melanoma, the changes have been classified as the ABCD’s of melanoma:

You should also be aware of other changes to your moles and seek medical advise if any of these changes occur:

• The mole suddenly or continuously gets larger.
• The skin around a mole becomes red or develops coloured blemishes or swellings.
• A mole that was flat or slightly elevated increases in height rapidly.
• A smooth mole develops scaliness, erosion or oozing. Crusting, ulceration or bleeding are signs of more advanced disease.
• Itching is the most common early symptom - there may also be feelings of tenderness or pain. Skin cancers however are usually painless.

Early detection of skin cancer is critical as it reduces the risk for spread to other areas of the body. Have your moles checked regularly by a dermatologist or your family doctor.

By: Dr. Jason K Rivers, BSc, FRCPC