Age spots on the hands and arms: causes and laser treatment

Hello. This is Dr. Lee Yumin of MeSOnBom Clinic.

People usually think of age spots as something that appears on the face.

But as the weather warms, the clinic fills with patients coming about an unexpected area.

Age spots on the backs of the hands and the arms.

Many say they are too embarrassed by how untidy their hands and arms look to wear short sleeves.

It is not only older patients: noticeably more people in their early to mid-forties now come in distressed that spots have already appeared on the backs of their hands.

Let me explain in detail.

Medically called seborrheic keratosis, age spots are known in English simply as age spots.

As the name says, they are a common benign lesion arising naturally with skin ageing.

Beyond ageing, environmental and genetic factors act together.

Continuous UV exposure: those who walk a dog daily, enjoy outdoor sports such as hiking, golf or tennis, or drive for long periods have hands and arms left unprotected as sunscreen rubs off easily, so spots can appear quickly.

Genetic factors: if family members developed multiple age spots from a young age, such as the early forties, it is very likely you have a skin type genetically prone to them.

Clinics treat age spots in various ways, but applying different lasers according to the thickness of the tissue and the depth of the lesion — dual tailored treatment — gives a good outcome.

Most early or thin lesions are treated safely with the Clarity II laser.

It selectively destroys melanin without irritating surrounding normal skin.

Treatment takes about a second per lesion, though there can be temporary burning immediately afterwards.

Within a day the lesion turns dark and a crust forms.

Long-standing spots raised thickly above the skin cannot be removed completely with a pigment laser alone.

Here the CO2 laser is used to remove the lesion precisely.

Because it removes skin finely, aftercare with a hydrocolloid dressing follows to support healing.

Facial skin has good circulation, so wounds heal and crusts come away within about a week.

The hands and arms, being at the extremities, regenerate more slowly than the face, so the course needs to be watched with patience.

A case: a woman in her mid-forties, under considerable stress from multiple age spots on the hands and arms from her early forties due to genetic factors. After Clarity II treatment, dense dark crusts had formed across the lesions by day three. By day 21 (about three weeks), the crusts on the arms had mostly come away naturally, with some remaining on the backs of the hands.

Age spots on the body keep their crusts longer, usually clearing entirely at around a month.

Where spots are very thick or widely spread, dividing treatment across two or three sessions at intervals of a month or more, rather than removing everything at once, is the wiser way to prevent scarring and clear them cleanly.

Home care matters as much as the laser treatment itself.

The limbs in particular readily develop pigmentation if care is neglected, so please keep to the following.

Avoid swimming pools and public baths, and never scrub or use a body scrub.

The more slowly and naturally the crust comes away, the more cleanly new skin grows.

Reapply the regenerative ointment prescribed at the clinic frequently to keep the area moist.

This speeds skin regeneration.

Sun exposure can cause secondary pigmentation. Wear long sleeves or use gloves or a cloth when going out to block UV light completely.

Severe itching can occur as the crust forms and heals. Never scratch; apply a soothing ointment, and if it becomes hard to bear, come in for an antihistamine.

Age spots that appear naturally with time cannot be prevented entirely.

Even after clearing them completely, more appear gradually after a year or two.

So rather than thinking of removing them once and for all, I recommend approaching it as light maintenance each time they appear, every year or two.

Now is the best time to treat the hands and arms, when UV light is easy to block and crusts can be covered with long sleeves.

The process is simpler than people expect and causes little disruption, so rather than feeling embarrassed about your hands, please have them treated and recover clear skin. Thank you.