Lentigo Solaris: Causes, Symptoms, and Treatment of Sunspots

There is one round brown spot (or a few), often on the cheek, temple, or forehead. The spots are uniformly brown and may slowly enlarge. There is no scaling. It is benign.

What is a lentigo?
A lentigo (synonyms: age spot, liver spot, sunspot; plural: lentigines) is a benign pigmented spot that commonly appears later in life on sun-exposed areas of the skin, such as the face, chest, and the backs of the hands. People with fair skin are more likely to develop lentigines. There is a clear relationship between the development of lentigines and cumulative exposure to UV rays (sunlight and tanning beds). UV rays damage the pigment cells in the skin, causing them to malfunction and produce excess pigment.

What does it look like?
A lentigo appears as one round brown spot (or several), often on the cheek, temple, or forehead. The spots are uniformly brown and may slowly enlarge over time. There is no scaling.
The diagnosis can usually be made easily by an experienced physician. If there is any doubt, a dermatoscope may be used to examine the pigmented spot under 20x magnification. In cases of suspected malignancy, a skin biopsy may be performed for examination by a pathologist.

photo: lentigo

Can a lentigo become malignant?

A lentigo is generally benign. However, in rare cases, it can become malignant. This results in irregular, dark brown or even black discoloration within or around the lentigo. A lentigo that becomes malignant is called lentigo maligna. Lentigo maligna is a precursor to melanoma, the most aggressive form of skin cancer. A melanoma that develops from lentigo maligna is referred to as lentigo maligna melanoma.
It is strongly advised to consult a doctor if a pigmented spot changes or causes symptoms.

photo: lentigo maligna

What is the treatment?
A lentigo is benign and does not require treatment.

Cosmetic treatments:

Cryotherapy (freezing with liquid nitrogen):
This destroys the superficial pigment-containing skin cells, which are replaced by new cells without excess pigment. However, this is a coarse treatment and may result in white spots or scarring.
Pigment laser treatment:
This method targets only the pigmented cells, minimizing the risk of skin damage. The risk of scarring is negligible. In the Netherlands, laser treatment for lentigines is not covered by health insurance. The cost for laser removal of a pigmented spot is approximately €100.

Treatment of lentigo maligna and lentigo maligna melanoma:
These conditions always require treatment, preferably by surgical removal.