When does a Freckle Become an Age spot?

Removing Age spots with Fraxel Laser, IPL, and PDT

By Kimberly Moskowitz, MS, MD


The familiar freckle is a cute little brown dot that eventually  shows up in childhood after  unprotected  sun exposure.  Contrary to popular belief, we are not born with freckles.  We are born with the ability to make freckles based on our genetics and skin tone, but our skin will not make a freckle if not  challenged by the sun to do so.

Melanocytes, the pigment producing cells in the skin, are stimulated by the sun’s ultraviolet radiation to overproduce melanin.  Like a callous, this is the skin’s way of protecting or shielding the skin’s deeper layers from injury.  This protective mechanism can manifest as a suntan, a freckle, or an “Age spot”.

Freckles are the initial manifestation of sun exposure and sun damage.  Freckles are round with smooth borders and are most numerous when we are young.  They darken in the summertime and fade in the winter.  As years go by and the summertime “freckles” fade you begin to notice that some of those cute little dots that once graced your cheeks and forehead remain, but morphed, into tan or brown spots with irregular borders.  Age spots, I presume?   So when exactly does this metamorphic calamity occur?

The term “age spot” is actually a misnomer or at least an overstatement.  These flat unsightly lesions on the backs of hands, the face, chest, and forearms, increase in proportion to the amount of sun exposure we accumulate over time. This means that they usually don’t show up on our skin until we reach our 30s or 40s.  As excess melanin becomes “clumped” in the skin, people with sunspots also develop mottled uneven skin pigmentation or melasma.  Although age spots become more prominent as we grow older, someone who’s endured significant sun exposure or indoor tanning can develop them as early as their teens or 20s. Age spots, more accurately called sunspots, are usually harmless, they don’t disappear in the winter, and sadly, they never go away unless they are treated.

As the 40s have become the new 30s and “baby boomers” have moved middle age from the 40s to the 50s, there are now more “middle aged” women than ever looking to preserve their youthful appearance.  So how do we heal these marks of time?  No doubt, the sun is the skin’s greatest enemy.   According to the American Academy of Dermatology, the best way to prevent all aspects of sun damage, including sunspots, wrinkles, and skin cancer, is to (1) minimize sun exposure, (2) apply, daily, a broad-spectrum SPF 30 sunscreen with Zinc Oxide, 30 minutes before going outside, and reapplied every 2-3 hours.  Topical creams containing Hydroquinone and Retin-A work together to slow down the production of abnormal pigment produced by melanocytes.  Topical Vitamin C (L-Ascorbic Acid) and Retin-A have been shown to scavenge free radicals; repair cancer-causing DNA mutations caused by the sun’s UV rays, and soften fine lines and sunspots.

As 2010 celebrated the 50th anniversary of the Laser, we have grown increasingly fascinated with light and its biodiversity in healing the skin and body.  Photorejuvenation aka IPL treatments are the “Gold Standard” for treating freckles, sunspots, dilated facial capillaries, and most forms of sun-damage.  A series of three to six, 15-minute treatments can eliminate 85-95% of sunspots.  If your face, neck, or chest have more severe damage including fine lines and wrinkles, Fraxel™ Repair or Fraxel Restore laser treatments erase sunspots and abundantly stimulate collagen in the dermis to tighten loose skin and restore youthful elasticity.  Fraxel™ is why many of those Hollywood actresses seem to be getting younger instead of older.  Fraxelä Repair, touted as “the non-surgical facelift”, instantly repairs and tightens sun damaged skin, making your skin look a decade younger in 7-10 days.

Lasers procedures such as Fraxel work by causing thermal injury to the skin, which then provokes a healing response.  These laser procedures produce dramatic results but we are learning that sometimes the nature of phototherapy does not lie entirely in thermal injury.  Researchers and clinicians have been working with non-invasive visible light in the form of Light Emitting Diodes (LED) that naturally stimulate intracellular processes that heal cells. Blue, red, and yellow LED lights are being used alone for wrinkle reduction, skin rejuvenation, and acne or to enhance the results of other procedures such as chemical peels, Lasers, Photodynamic Therapy (PDT) and IPL.  Red and Yellow lights have been shown to increase collagen production, reduce abnormal melanin production, and reduce the healing time of Fraxelä treatments by as much as 50%.

While there may be a fine line between a freckle and an “age spot”, the future of aging skin looks bright; however, it is critical to start protecting and repairing your skin early because, after all, Sun damage doesn’t happen over night.

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Posted in: Age spots Hands, Age Spots- Getting Rid of Age Spots, Fraxel Repair Laser

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