Lentigo: Causes, Symptoms, Diagnosis, and Treatment
Lentigo is a common dermatological condition that appears as small, sharply defined, pigmented spots on the skin. These lesions are usually benign but can be a source of cosmetic concern for many individuals. Understanding the different types of lentigines, their causes, and available treatments is crucial for maintaining healthy, even-toned skin. At our clinic, we aim to educate our patients and provide advanced solutions for diagnosis and treatment.
What is Lentigo?
A lentigo (plural: lentigines) is a flat, brown, or black spot on the skin caused by an increased number of melanocytes, the cells that produce pigment. Unlike freckles, lentigines do not darken significantly with sun exposure, and they tend to persist year-round.
Lentigines can appear on any part of the body but are most common on sun-exposed areas such as the face, hands, shoulders, and upper back. They can develop at any age but become more frequent as people get older.
Types of Lentigo
There are several types of lentigines, each with its own characteristics:
1. Lentigo Simplex
Usually appears in childhood or early adulthood.
Found on skin areas not necessarily exposed to the sun.
Typically small, light to dark brown, and uniform in color.
2. Solar Lentigo (Sun Spots or Age Spots)
Caused by chronic sun exposure.
Common in older adults.
Appear as larger, tan-to-dark-brown patches, often on the face, forearms, and hands.
3. Ink-Spot Lentigo
Small, dark, irregularly shaped spots.
Often seen after sunburn.
Considered benign but may resemble other pigmented lesions.
4. PUVA Lentigo
Develops after psoralen plus ultraviolet A (PUVA) therapy.
Appears as small, dark macules in treated areas.
5. Lentigo Maligna
A precancerous form that can evolve into melanoma.
Appears as a slowly enlarging brown or black patch, usually on sun-damaged skin of the face in older adults.
Requires prompt medical evaluation and possible biopsy.
Causes and Risk Factors
Lentigines develop due to an overproduction of melanin, often triggered by:
Chronic sun exposure (UV radiation)
Tanning beds and artificial UV light
Hormonal changes
Genetic predisposition
Certain medications or skin conditions
Fair-skinned individuals, people with a history of sunburns, and those who spend significant time outdoors are at higher risk.
Symptoms and Clinical Appearance
Lentigines are characterized by:
Flat, well-defined spots
Color ranging from light brown to black
Size from a few millimeters to over 1 cm
No scaling or roughness
Persistence throughout the year
Unlike freckles, they do not fade in winter and are usually more prominent with age.
Diagnosis of Lentigo
A dermatology provider can diagnose lentigo by visually examining the skin. In some cases, dermoscopy or a skin biopsy may be performed to differentiate lentigo from other pigmented lesions such as seborrheic keratoses, nevi, or melanoma.
If you notice sudden changes in size, shape, or color, or if the lesion becomes irregular, a medical evaluation is necessary to rule out skin cancer.
Treatment Options for Lentigo
While most lentigines are benign and do not require treatment, many individuals choose to lighten or remove them for cosmetic reasons. Treatment options include:
1. Topical Creams
Hydroquinone, tretinoin, or corticosteroids may help lighten pigmentation over time.
Requires consistent use and monitoring by a dermatology provider.
2. Chemical Peels
Superficial peels using glycolic acid, salicylic acid, or trichloroacetic acid can lighten dark spots.
Best performed by a trained professional to avoid irritation or scarring.
3. Cryotherapy
Liquid nitrogen is applied to freeze and destroy excess pigment cells.
Quick procedure but may cause temporary redness or hypopigmentation.
4. Laser Therapy
Intense Pulsed Light (IPL) or Q-switched lasers specifically target pigment.
Offers excellent cosmetic results with minimal downtime.
5. Surgical Excision
Rarely needed but may be performed if a lesion is suspicious for malignancy.
Prevention of Lentigo
Preventing lentigines largely revolves around sun protection:
Apply a broad-spectrum sunscreen (SPF 30+) daily.
Wear protective clothing, hats, and sunglasses.
Avoid peak sun hours (10 AM – 4 PM).
Avoid tanning beds.
Schedule annual skin checks with a qualified provider.
When to See a Dermatology Provider
It is important to seek professional care if:
A spot changes rapidly in color, size, or shape.
The borders become irregular or notched.
The lesion becomes painful, itchy, or starts bleeding.
You are unsure whether a dark spot is benign.
At My Skin St. Pete and My Skin Bradenton, Leah Michel, APRN, FNP-BC, brings over 8 years of dermatology experience to help you with diagnosis, prevention, and treatment of lentigines and other skin concerns.
Final Thoughts
Lentigines are common, benign, and manageable, but monitoring changes in pigmented lesions is essential to rule out precancerous or cancerous conditions. With proper sun protection and professional care, you can maintain healthy, youthful-looking skin and minimize the appearance of new spots.
Disclaimer:
The information on this website is provided for educational and information purposes only and is not medical advice. Always consult with a licensed medical provider and follow their recommendations regardless of what you read on this website. If you think you are having a medical emergency, dial 911 or go to the nearest emergency room. Links to other third-party websites are provided for your convenience only. If you decide to access any of the third-party websites, you do so entirely at your own risk and subject to the terms of use for those websites. Neither My Skin by Leah Michel, APRN, FNP-BC, nor any contributor to this website, makes any representation, express or implied, regarding the information provided on this website or any information you may access on a third-party website using a link. Use of this website does not establish a doctor-patient relationship. If you would like to request an appointment with a health care provider, please call our office at (727) 295-7223.
