Age spots – also called liver spots and solar lentigines – are flat gray, brown or black spots. They vary in size and usually appear on the face, hands, shoulders and arms – those areas most exposed to the sun.

Q: What are the symptoms of age spots?

A: Although age spots typically develop in people with a fair complexion, they can also be seen in those with darker skin.

Age spots are:

• Flat, oval areas of increased pigmentation

• Usually brown, black or gray

• Occur on parts of the skin that has had the most sun exposure over the years, such as the backs of hands, tops of feet, face, shoulders and upper back

• Can range from freckle-size to more than a half inch (1 centimeter) across and can group together, making them more prominent

Q: What causes age spots?

A: Age spots are caused primarily by years of exposure to ultraviolet (UV) light from the sun. Tanning beds can also contribute to the development of age spots. The pigment in the upper layer of skin (epidermis) that gives your skin its normal color is called melanin. UV light accelerates the production of melanin, creating a tan that helps protect deeper layers of skin from UV rays.

On areas of the skin that have years of frequent and prolonged sun exposure, age spots appear when melanin becomes “clumped” or is produced in particularly high concentrations. In addition to sun exposure, simply becoming older can cause the extra production of melanin.

Q: What treatments are available?

A: If you’re unhappy with the appearance of age spots, treatments are available to lighten or remove them.

Medications. Prescription bleaching creams (hydroquinone) used alone or with retinoids (tretinoin) and a mild steroid.

Laser therapy. Laser therapy destroys melanin-producing cells (melanocytes) without damaging the skin’s surface. Treatments with a laser typically require several sessions.

Freezing (cryotherapy). This procedure involves applying liquid nitrogen or another freezing agent to the age spots to destroy the extra pigment. As the area heals, the skin appears lighter. Freezing is typically used on a single age spot or a small grouping of age spots.

Dermabrasion. This procedure consists of sanding down (planing) the surface layer of your skin with a rapidly rotating brush – removing the skin surface. A new layer of skin grows in its place.

Chemical peel. A chemical peel involves applying an acid, which burns the outer layer of your skin, to the age spots. As your skin peels, new skin forms to take its place

True age spots are harmless and don’t require treatment. However, if you have spots that are dark or have changed in appearance, you should consult a dermatologist because these changes can be signs of melanoma, a serious form of skin cancer.

Dr. Oswald Lightsey Mikell, certified by the American Board of Dermatology and the American Board of Cosmetic Surgery, is the owner of Dermatology Associates of the Lowcountry.