Cosmetic Surgery Blog

While I am on the beach, my coworker and friend Beth Longware Duff has written a blog entry for us. Beth is a medical writer with NewImage.com and has written for many mewspapers and magazines. She has won awards for her medical writing, including the American Cancer Society Media Award. — Valerie

I’ve reached that stage in life (just north of 50) where I’ve begun to notice that some of the changes associated with – dare I say it? – aging are manifesting themselves in and on me. Now, I can deal with a little stiffness in the morning, I’ve adapted fairly well to bifocal lenses, and I’m working on that dab of middle age spread that’s made itself at home in my midsection. But nobody warned me about age spots! I mean, where did those come from?

Well, I know from whence they came: sun exposure that occurred decades ago. First, I should note up front that I hold true to my Swedish roots. I’m blonde, blue-eyed, and fair-skinned – the kind of fair skin that burns, and quickly, when exposed to the sun. As a child I had a dusting of freckles across my high cheekbones and broad shoulders, many of which linger to this day. Mind you, this was in the days before the alphabet soup of PABA, SPF, UVA, and UVB. We’re talking back when we bought bottles of suntan lotion, not sunscreen protection. Heck, we’re talking about slathering up with pure baby oil and lying out in the sun for hours on end at midday!

Growing up in northern New York State, cultivating a deep, dark tan was one way I could keep the sweet memories of summer alive throughout the long, snowy winter, and I was proud that my tan lines were still visible come spring. Of course, knowing what I do today, it was a dumb thing to do, and I’m no longer a sun addict. But the reformation didn’t come early enough to avoid sun damage that is now most apparent in the form of age spots.

Actually, age spots is a misnomer. These flat, gray, brown, or black patches really should be called sun spots, because dermatologists (who refer to them as solar lentigos or lentigines) will tell you that it’s the sun that causes them, not the aging process. It’s just that it takes many, many years for them to surface, usually right about the time we get concerned about aging.

Sun spots fall into the category of photoaging, or aging caused by exposure to the sun’s rays. The sun damages the melanocytes, the cells on the skin’s surface layer that produce melanin, the pigment that absorbs sunlight and protects us from the UV rays. The result is freckles and brown spots. The amount of photoaging a person experiences depends on two factors: his or her skin color and their history of long term or intense sun exposure. Lighter skin tone + longer exposure = greater potential for damage. The equation holds for commercial sunlamps and tanning beds, too.

My age spots are relatively small in size, but big enough to bother me. They’re primarily on my upper chest and shoulders, where they’re easy to cover up during most of the year but annoyingly apparent when I switch to tank tops for the summer. They can also crop up on the face, the backs of the hands or tops of the feet, and arms – generally the areas of the body that are most exposed to the sun. Sometimes they flock together, like a bunch of flamingos, making them really stand out. Continued sun exposure can result in more sun spots, which tend to grow if left untreated.

When I first noticed these spots, I brought them to the attention of my dermatologist. He assured me that they were, indeed, sun spots and not cancerous. Still, I keep an eye on them. Any lesion on the skin can be cancerous, and if they change in any way I’ll run them by the dermatologist again.

In the meantime, I’ve started researching my options for getting rid of them. Over-the-counter fade creams would be easiest, but they also take the longest to work and I’ve read that the products out there tend to bleach the skin around the spots more than the spots themselves; highlighting my sun spots is definitely not the look I’m going for. Laser therapy actually destroys the melanocytes that created the sun spots. The process requires several treatments and it’s expensive, plus my one experience with an IPL laser was not pleasant. Cryotherapy, or freezing the spots off with liquid nitrogen, is acceptable to me, but there is a slight risk of permanent scarring or discoloration, so would I really be any farther ahead? Dermabrasion (sanding down the skin) and chemical peels (burning off the skin) are also effective for sun spots, but a little too invasive for my tastes.

So, while I ruminate about sun spots, I can get back issues of greater concern: skin tags, spider veins, and an assortment of fine lines on my face. One thing’s for sure: aging sure ain’t for sissies!