Lentigines (spots) are benign skin color lesions which gradually occur in older people and are usually the result of early or normal aging of the skin due to the modern lifestyle and mainly due to chronic sun exposure. They occur in areas such as the face, hands, neckline and show a tendency for proliferation and increase in their size, which initially does not exceed 2‑3 cm. Their color (light brown to dark brown/black) is due to the overproduction of melanin from the melanocytes, as a skin protection process from sunlight.
Liver spots (medical term / Melasma or Chloasma) are brown skin lesions with a size larger than spots and an irregular shape. Their occurrence is sudden following a hormonal disorder, the use or topical application of drugs that increase photosensitivity and during pregnancy. Their occurrence is directly related to exposure to solar radiation and thus, the problem with the hyperpigmented lesions becomes highly noticeable during the summer months, whereas in autumn/winter they regress or completely disappear. They are mainly found on the face, usually the forehead, upper lip and cheeks.
The terms spots – lentigines are practically used in everyday clinical practice without distinction in order to practically describe the same lesions, whereas when they occur in people over 60 years of age they are often called aged spots.
Because spots and lentigines belong to the same category of hyperpigmented skin lesions, their clinical picture exhibits several similarities with nevi (moles) without, however, having the same growth mechanism. Thus, the examination of patients with suspicion of spots or liver spots should be done by an experienced clinical dermatologist, in order to make a definite diagnosis and subsequently determine the treatment.
CO2 Laser. Localized elimination of brownish spots is achieved, whereas the surrounding healthy skin is left intact. The healing of superficial erosions is rapid and does not leave any scars.
Fractional CO2 Laser. Due to its special mode of action, it allows us to remove the pigmented lesions from both the upper layers of the epidermis and the deeper dermis, while achieving skin regeneration through the production of new collagen and elastin, the latter resulting in a rejuvenated appearance of the skin.
Cryotherapy with liquid nitrogen – It is mainly used in hyperkeratotic type spots – liver spots, i.e. the ones that protrude from the surface of the skin.
Dermabrasion with microcrystals – Several sessions are required in combination with bleaching creams so as spots are eliminated
Chemical peeling, which is mainly performed with trichloroacetic acid (TCA) in strengths over 25%.
Lentigines – Liver spots (Melasma)
Chemical peeling – Chemical solutions, such as trichloroacetic acid, glycolic acid and Jessner solution are used, as apart from their good exfoliating action they also have high depigmentation properties. The best time to start treatment is at the end of summer.
CO2 Laser – It achieves a uniform removal of the part of the skin that presents intense pigmentation.
Fractional CO2 Laser. Its application is indicated even for the deepest blemishes in the dermis, as its Laser beam penetrates deep into the subcutaneous tissue.
Dermabrasion with microcrystals, in cycles of at least 8‑10 sessions.
Topical application of bleaching formulations with ingredients such as hydroquinone, isotretinoin, vitamin C, cortisone, azelaic acid.
Cryotherapy with liquid nitrogen with limited efficacy.
All of the above treatments can be applied independently or in combination for better and faster results. The decision for the appropriate treatment protocol as well as its implementation belongs exclusively to an experienced clinical Dermatologist.
Cosmetic Derma Medicine is specialized in all the aforementioned treatments. Moreover, in Cosmetic Derma Medicine you can find the appropriate equipment with the latest generations of lasers that guarantee the most successful treatment.
An important parameter to prevent relapses following a successful treatment is to avoid uncontrolled sun exposure and to use sunscreen with a high protection.