Solar lentigo, also known as actinic lentigo is common in fair skinned individuals who sunburn easily and do not tan. Although commonly occurs in aging individuals over 50, but now it is increasingly seen in young adults who are exposed to excessive sunlight. Unlike freckles which usually fades or even disappear after sun exposure is avoided, solar lentigo may not fade after sun exposure is avoided. They are sometimes called liver spots but are not due to any systemic disease or liver disease.
Solar lentigo commonly occurs on sun exposed areas of the body, but it can also be seen on sun protected sites like penis and buttocks that might have been exposed to photochemotherapy. Solar lentigo may appear at any time of life and are usually circumscribed, brown to jet black, pigmented macules which are either single or multiple and common on the face, arms, dorsa of the hands, and upper part of the trunk.
Other Possibilities to Consider
There are several other conditions that might be confused with solar lentigo. Few of them are given below:
Freckles or ephelis
Reticulated seborrheic keratosis
Pigmented actinic keratosis
Junctional nevomelanocystic nevus
Solar Lentigo Treatment
Usually no treatment is required for solar lentigo, but increasing in number may indicate excessive exposure to UV radiation which is also thought to be a risk factor for skin cancer. Several treatment options are discussed in literatures including intense pulsed light (IPL), laser therapy with frequency-doubled Q-switched Nd:YAG laser and topical agents like retinoids and trichloroacetic acid (TCA) peels. However for few solar lentigo cryotheraoy may still be considered as first line of treatment. It is important to remember that with either of the treatment there are possibilities of recurrence. Also using bleaching creams containing hydroquinone are usually not effective.
Although, majority of solar lentigos progress little and may usually become stable over time, a small percentage of it may slowly progress to lentigo maligma. Always consider visiting dermatologist if you see any unusual or changing lesion to exclude melanoma.
As we learn “Prevention is better than cure” so we can prevent further solar lentigines by reducing UV radiation exposure. This may be achieved by using broadspectrum sunscreen of atleast SPF 30 and protective clothing. This measures if used during early childhood and continuous throughout the life may prevent solar lentigines as well as other benign and malignant conditions that are caused due to excessive sun exposure.