Lentigines - Liver Spots

The terms spots or lentigines are practically used in everyday clinical practice, without distinction, in order to describe the same lesions, whereas when they occur in people over 60 years of age, they are often called age spots.

Dr. Amalia Tsiatoura
As explained by Dermatologist - Venereologist Dr. Amalia Tsiatoura "the appearance of liver spots or lentigines is due to a malfunction of the melanin cells of the skin, resulting to an increase in melanin production. At Cosmetic Derma Medicine, the modern Dermatological treatments and the latest generation Laser equipment we have, are applied independently or in combination, aiming for the best and most immediate results".
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Lentigines - Liver Spots

Liver Spots

Lentigines or Melasma are defined as skin lesions that are brown in color, larger than spots and vaguely outlined in shape. The term chloasma is often used to describe melasma. It is an acquired hyperpigmentation of the skin and is mainly caused by chronic and cumulative exposure to the sun. They are very common skin lesions and are most pronounced in women with darker skin.

Lentigines can be easily diagnosed, even with an experienced naked eye, because of the characteristic brown spots that appear on the face. For the effective treatment of freckles, it is recommended to identify the cause that led to their appearance in the first place be determined, so that they can be treated appropriately.

The term Freckles is used to describe benign skin pigmentary lesions, light or dark, which appear gradually in older people and are usually the result of normal or premature skin ageing due to modern lifestyles, especially chronic sun exposure. They appear on areas such as the face, hands and décolleté and tend to proliferate and increase in size, initially not exceeding 2-3 cm.

Over the years, normal ageing of the skin occurs, which can be accelerated when the person has been exposed to sunlight (photo-ageing). Signs of both normal ageing and photo-ageing include thinning of the skin, spider veins, haemangiomas, lesions and the appearance of spots, known as 'age spots'.

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Lentigines - Liver Spots




The lesion is confined to the surface of the skin and has a brown coloring. It is due to excess melanin in the superficial layers of the skin. It shows a fairly good response to treatment.


The lesion is very deep, with indistinct borders and almost black in color. It is characterized by the presence of melanophages - cells that 'eat' melanin - in the skin. It has a relatively good response to treatment.


The lesion is of intermediate depth, with fuzzy borders and dark brown coloring. It is a combination of the epidermal and cutaneous types. The mixed type is more difficult to treat.

Ακαθόριστος τύπος

Has a higher incidence in darker skin.
Lentigines - Liver Spots


Daily exposure of the face to intense sunlight, regardless of the season, is the main factor for the appearance of lentigines. Lentigines on the body are mainly formed in summer with the obvious cause being increased melanin production.

Also, in women who are genetically predisposed, the appearance of lentigines may be accelerated due to hormonal problems, such as polycystic ovaries, or due to the use of contraceptives. Often, lentigines occur due to an inherited predisposition or due to genetic factors.

Lentigines can be easily diagnosed, even with an experienced naked eye, because of the characteristic brown spots that appear on the face. For effective treatment of lentigines, it is recommended to first determine the exact cause that caused their appearance in the first place, so that they can be treated appropriately.

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Poor diet

Skin infections

Liver problems

Dehydration of the skin



Smoking and alcohol

Use of perfumed cosmetics

Lentigines - Liver Spots


Spots caused by the sun

Spots due to hormonal changes

Spots due to ageing

Spots due to cosmetic or pharmaceutical products

Lentigines - Liver Spots


For the proper treatment of Lentigines – Liver Spots, the skin must first be properly checked to confirm the cause. Furthermore, the reason for their appearance must be understood, so that other, more serious causes can be excluded. A qualified Dermatologist is able to make a correct diagnosis and propose an appropriate treatment for the treatment and elimination of Lentigines – Liver Spots.

Chemical Peeling

Microdermoabrasion is successfully applied in cases of treatment of Lentigines – Liver Spots and needs at least 8-10 sessions to achieve the desired results. The microcrystals are ejected and suctioned by a special device and remove dead skin cells. It is a simple and painless treatment that allows the patient to return to work immediately, without leaving any pain or irritation.

Bleaching substances

The application of topical bleaching preparations for the treatment of spots is considered a fairly safe solution, but should be avoided during the summer. They do not lead to immediate and complete results, but lead to a gradual discoloration of the spots until they are no longer so visible.


The treatment of spots with Cryotherapy or Cryosurgery, although it is an older method, is still practiced. With cryotherapy, liquid nitrogen is applied locally, causing the skin temperature to decrease, which leads to the destruction of the pathological tissues. The cold causes local vasoconstriction and necrosis at the site where it is applied.


Microdermabrasion is successfully applied in cases of treatment of lentigines and requires at least 8-10 sessions to achieve the desired results. The microcrystals are ejected and suctioned by a special device and remove dead skin cells. It is a simple and painless treatment that allows the patient to return to work immediately, without leaving any pain or irritation.

Lentigines - Liver Spots

Treatment with CO2 Fractional Laser

The most common and effective method of treating lentigines is CO2 Fractional Laser. This method is extremely safe and gives visible results in just a few sessions. With the CO2 Fractional Laser, we can intervene locally, in very small areas of the skin and achieve deep penetration. This avoids the effect of the laser on the areas that do not require treatment. Essentially, the laser targets a very specific spot and emits a precise dose of light energy, aiming to eliminate hyperpigmented areas. After treatment there may be mild irritation in the area, which disappears on its own after 1-2 days.

Fractional Laser CO2 is extremely safe and gives visible results in just a few sessions.
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Treatment by qualified dermatologists


Local intervention on very small areas of the skin

Immediate Action

Immediate result within a few sessions
Lentigines - Liver Spots


What is melanin and how does it contribute to the formation of lentigines?

Melanin is a family of skin pigments and is produced from the amino-acid tyrosine. There are 3 main types of melanin: eumelanin, pheomelanin and neuromelanin. Melanin is produced in specialized skin cells called melanin cells. Melanin cells are located between the cells of the basal layer of the epidermis and are derived from cells of the neural crest. The eumelanin they produce is a strongly brownish pigment that gives the dark color to the skin and hair. Phaeomelanin is a component of red hair. The higher the levels of melanin in the body, the darker the skin color. At the same time, melanin protects the skin from harmful solar radiation, resulting in protection from skin cancer.

Any abnormalities in the melanin cells and thus in the production of melanin lead to the appearance of characteristic discolorations on the surface of the skin, i.e. the appearance of blotches and spots. Spots and patches belong to the category of hyperpigmented skin lesions and show several similarities with moles in their clinical appearance, without, however, having the same mechanism of development. Therefore, the examination of patients with suspected keloids or nevi should be performed by an experienced Clinical Dermatologist, in order to clearly establish a diagnosis that will determine the subsequent treatment. They are an aesthetic problem, which afflicts both men and women.

To whom do Lentigines occur most often?

Although there is a possibility that they can also appear in men, freckles mostly appear in women 9 times more often than in men. The occurrence is more frequent darker in skin because in these skin types the melanin cells, the cells responsible for the production of melanin, are more easily stimulated.

Their appearance occurs suddenly after a hormonal imbalance, medication or topical application of drugs that increase skin photosensitivity, as well as during pregnancy. The problem becomes strongly visible with exposure to sunlight, especially during the summer months, while in autumn/winter they subside or disappear completely. Their main location is the face, usually the forehead, upper lip, cheekbones and cheeks.

I suddenly developed lentigines during pregnancy. Why did this happen?

Lentigines that appear during pregnancy are also called "pregnancy mask" and occur due to increased levels of estrogen and melaninotropic hormone. They are a fairly common skin phenomenon. Lentigines that first appear during pregnancy usually disappear on their own a few months after childbirth. If the spots remain for a long time after childbirth, they may become more severe or worse. It should be noted that they are not a skin condition, but are mainly a cosmetic problem.

Can I follow a treatment against lentigines during pregnancy?

It is recommended that pregnant women, as well as mothers who are in the breastfeeding stage, should not follow treatments against lentigines, as the change in hormones present in pregnancy can aggravate the already existing lentigines - freckles and the treatment may not have a significant effect.

What is definitely required during pregnancy and lactation is the use of a high index sunscreen in order to prevent spots and melasma from worsening and new ones from appearing.

Are the spots that appear at older ages dangerous to health?

The so-called "age spots" are easily visible and often lead to psychological distress for patients. They have not been shown to have a risk of flare-ups, but their presence sometimes makes early diagnosis of skin cancer difficult. For this reason, but also for aesthetic reasons, their treatment is recommended.

What are the main causes of freckles?

Possible causes of lentigines include exposure to sunlight, lack of iron, magnesium or vitamin C, skin dehydration, skin injuries, as well as hereditary causes.

Hormonal changes during pregnancy, as well as taking birth control pills can also be triggering causes of spots - blotchy spots and melasma.

How can I prevent the appearance of lentigines?

Prevention is quite difficult and requires great care and discipline. However, avoiding sun exposure can delay or in rare cases stop the appearance of lentigines. In any case, the use of sunscreen products with a high protection factor is recommended.

Is it easy to deal with lentigines?

Lentigines can in some cases be treated quickly and effectively. Especially the epidermal or mixed type of lentigines respond to treatment with great success. Epidermal lentigines are more difficult to treat, but are treated just as effectively.

Mixed type is usually the most difficult to treat and require a combination of treatments to achieve the best possible result.

What should I avoid after CO2 Fractional Laser treatment?

After Laser application for the treatment of lentigines, exposure to the sun should be avoided, as well as any method of artificial tanning.

Moisturizing - regenerating creams and sunscreen products are necessary after the treatment.

Why should I choose Cosmetic Derma Medicine for the treatment of lentigines?

Cosmetic Derma Medicine Medical Group is the largest and most specialized medical group in the field of Dermatology and Plastic Surgery, with 16 clinics in Greece and Cyprus.

The Scientific Director of Cosmetic Derma Medicine is Dermatologist - Aphrodisiologist Dr. Amalia Tsiatoura, while the staff consists of a medical team of highly experienced and specialized doctors of many different specialties, as well as a fully qualified team of nurses. Our team is at your side every day, 24/7 for whatever you need.

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You can send us your request by phone or e-mail and we will get back to you the soonest possible with more information on our top quality services on Dermatology and Plastic Surgery, all at your disposal at Cosmetic Derma Medicine!

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