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As we get older, the signs of visible aging begin to show on our skin. In addition to fine lines and wrinkles, one of the most obvious signs of aging are sun spots, also known as “liver spots” which develop. These liver spots start to appear on our face, hands, arms, neck, and shoulders. Liver spots, also known as age spots, or solar lentigines, are brown or tan flat patches that form as a result of excessive sun exposure. These flat, circular spots of darkened skin are not dangerous but can be distressing cosmetically, as they develop in highly visible areas – the same areas of skin that are most often exposed to the ultraviolet rays of the sun. Unlike freckles which may fade over time, liver spots tend to coalesce over time and grow larger and more prominent. Age spots are most common in adults over 50 years of age and are often confused with skin cancer. Sun spots are entirely benign but cosmetically unattractive. Cosmetic dermatologists, like Dr. Michele Green in NYC, specialize in the removal of unwanted pigmentation, as a result of sun exposure, liver spots and age spots.

There are many different treatment options for removing age spots that range from laser treatments with Fraxel, Clear + Brilliant laser, Alex-TriVantage, Intense Pulsed Light (IPL), chemical peels, Cosmelan peels, to bleaching creams with hydroquinone, to microneedling with skin lightening serums, and more. Many treatments for liver spots work by removing the pigment that make up the age spots or by blocking melanin production in the pigmented area of of the skin, and keeping the skin light and bright. Lasers, such as the Fraxel and Alex-Trivantage, destroy the melanin and leave the remaining skin unaffected. The goal in removing sun spots is to remove the unwanted pigmentation and promote the production of new collagen, which has the added benefiting of making the skin look healthier and younger. When you are navigating your treatment options for removing liver spots, it is best to consult an expert, board certified dermatologist, like Dr. Michele Green, who can help to determine the best treatment plan for you.

Dr. Green has been treating patients with age spots and other unwanted skin pigmentation issues in her Upper East Side office in New York City for more than 25 years. An expert in chemical peels, Cosmelan, skin care, pigmentation and laser treatments, Dr. Michele Green has been consistently voted as one of the best dermatologists in New York by New York Magazine, Castle Connolly, The New York Times, and Super Doctors. She has created a line of skin care, with MGSKINLABs, to promote healthy skin, remove pigmentation and sun damage. Whether it be sun spots, liver spots, melasma, generalized hyperpigmentation or uneven skin tone, Dr. Green is here to help.

What are liver spots?

Liver spots, also known as age spots, sunspots, or solar lentigines, are flat, circular, brown spots that develop as a result of excessive exposure to the sun’s ultraviolet (UV) rays. These liver spots form over time as your body’s reaction to protecting itself against sun exposure. The name “liver spots” is a confusing misnomer, as the spots have nothing to do with the function of the liver and instead are formed as a direct result of sun damage. These age spots are not dangerous and can be removed for cosmetic reasons, if you find yourself dissatisfied with their appearance on the skin.

Where do liver spots come from?

Liver spots form as a direct result of sun exposure over a prolonged period of time. UV rays are harmful to the skin and so the body reacts by over producing melanin to protect the skin. Melanin is a type of pigment that gives color to your hair and skin. Melanin is produced by cells called melanocytes located in the epidermis, or top layer of skin. The pigmentation serves to absorb the UV rays when sunlight hits the skin, which protects the DNA from damage. The amount of melanin in your body is directly related to your skin type, or skin tone, meaning that those with lighter skin have less melanin whereas those with darker skin have more melanin. For that reason, people with lighter skin are more likely to develop liver spots and sun spots than those with darker skin tones. When people of all skin tones are exposed to direct sunlight, the body reacts by over-producing pigmentation to help absorb the UV rays, which leads to the creation of melanin-rich lesions, or liver spots. The result is that liver spots and age spots form on the areas of the body that have the most direct exposure to sunlight such as the face, hands, and arms, where protective clothing is not typically worn.

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45-54 year old woman treated for age spots

What are the risk factors for developing liver spots?

Liver spots, or age spots, are very common, particularly for those over 50 years of age. However, there are certain risk factors that may make you more likely to develop liver spots over time. Liver spots develop as a result of sun damage and, as such, those who have had intense or frequent exposure to the sun are more likely to develop liver spots. Also, people who have had a history of severe sunburns are also more likely to have these dark spots form on their skin. Another risk factor is skin type, or skin tone. Those with lighter skin types have naturally less melanin in their skin. As a result, people with lighter skin are more likely to be at risk for developing this skin discoloration. However, patients with dark skin tones are also sensitive the sun exposure and suffer from sun spots and facial melasma.

Do liver spots go away?

Unlike freckles, which can fade over time, liver spots do not typically disappear on their own. Freckles are small spots of pigmentation which are more common in younger people, which are more prominent in the summer time and fade in the winter. Freckles can sometimes  become less pronounced as we age. Liver spots, however, form over many years of sun exposure and become more prominent with age. If you would like to eliminate liver spots, you will need to do so with a cosmetic dermatological procedure, such as chemical peels, laser treatments or skin lightening creams.

Can liver spots be removed?

Yes! While true liver spots are not actually dangerous, patients can choose to have them removed for cosmetic reasons. When many patients hear the phrase “removed,” they automatically think of cryotherapy, which is when liquid nitrogen is applied to the melanin-rich lesion to freeze the pigmented cells. Eventually, the sunspots, damaged by the freezing, will fall off. However, this treatment method is outdated and Dr. Green uses alternate treatments in her office that are both more effect, and less uncomfortable.

How to get rid of liver spots

There are many treatment options to have your liver spots eliminated and the best first step is to schedule a consultation with Dr. Michele Green so she can examine the area and make a recommendation for the best cosmetic treatment for you. Dr. Green will assess the location, size, and severity of the age spots in order to determine the treatment or combination of treatments that will eliminate the lesions and ensure that the sun spots do not return. The treatment options in Dr. Green’s office include laser therapy, intense pulsed light therapy, chemical peels, HydraFacials, Microneedling, Vivace, Cosmelan, Mesopeels, and a variety of topical creams and broad-spectrum sunscreens to eliminate sunspots, lighten the skin, and protect the skin from further age spots.

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AlexTrivantage for sunspots, male patient

Laser treatments to remove sun spots:

There are several varieties of laser treatments available in Dr. Green’s office, each serving a slightly different function. Dr. Green will determine the laser treatment that is best for you by assessing the size and location of the melanin-rich lesion as well as your skin type. Laser treatment works by emitting a wavelength of light into the dermis, which targets the pigment-rich areas of the skin. The light is absorbed by the pigmented cells and is then converted into heat energy, which destroys the melanin-rich cells. The body then produces new skin, which is lighter, brighter, and younger-looking. Laser treatments are safe and effective, and permanently remove liver spots as long as you take care not to expose the skin to direct sunlight following the treatment.

Candela Alex-Trivantage Laser

The Candela Alex-Trivantage Laser is designed to treat discreet, localized liver spots. The Candela Alex-Trivantage is an ndYag laser that eliminates pigmented lesions with no discomfort and little recovery time. Depending on how dark the sunspot is, you may need one to two treatments in order to fully remove the discoloration and undesired pigmentation. The effect of the treatment become visible 1 to 2 weeks after receiving the procedure. If a second treatment is needed, a one month interval is needed to best allow the skin to heal between desired treatments.

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AlexTrivantage for dark spots on the arm

Fraxel Laser

The Fraxel lasers has two different wavelengths that can be used to treat sunspots, hyperpigmentation, actinic keratoses, and acne scars, fine lines, wrinkles respectively. The 1550 wavelength is best suited to treat fine lines, wrinkles, and acne scars, while the 1927 setting is used to treat discoloration such as liver spots. The two settings can be used in combination to treat many signs of the natural aging process – at once eliminating wrinkles and liver spots. When treating pigmentation, the Fraxel Laser is designed to target melanin in the pigmented cells while leaving the surrounding skin unaffected. For that reason, however, Fraxel Lasers are best used for patients with lighter skin in order to avoid any unnecessary side effect for patients with darker skin tones. Depending on the degree of pigmentation, the number of sun spots, and the degree of sun damage, you may need three Fraxel laser treatments to remove all of the unwanted pigmentation. Each Fraxel laser treatment should be scheduled one month apart for optimal cosmetic results. For patients with darker skin tones, the Clear + Brilliant laser may be a more appropriate option for removing unwanted liver spots and sun spots.

Clear + Brilliant Laser

The Clear + Brilliant Laser is sometimes referred to as the “mini-Fraxel” laser, as it best used to treat smaller areas of pigmentation. The Clear + Brilliant Laser is also advantageous as it can be used on patients of almost all skin types from light skin tones to darker skin tones, and is safe and effective for all. With the Clear + Brilliant Laser treatment, patients can expect skin rejuvenation in addition to the elimination of pigmentation, as the laser dispels the melanin-rich lesions and triggers the production of collagen for new, healthy skin. While effects of the treatment can be seen almost immediately following the procedure, Dr. Green recommends five to six treatment sessions, depending on the severity, in order to produce the best results. There is no recovery time after the Clear + Brilliant laser and patients can resume their daily schedule without any side effects.

Intense Pulsed Light (IPL) Treatment

Intense Pulsed Light (IPL) Treatment, also known as photo-rejuvenation or a photofacial, uses wavelengths of light to treat pigmentation and fine lines, as well as improve the texture and feel of the skin. Unlike most lasers, which use a single wavelength of light, IPL treatment uses several different wavelengths of light to combat the signs of aging on many levels. When the IPL device is applied to the skin, it emits a wavelength of light that penetrates the dermal layer of the skin and is absorbed into the melanin-rich lesion. The pigmented cells that make up the liver spot convert the light energy into heat, which destroys the pigmented cells. This triggers the production of collagen, which leads to the creation of new, healthy skin.

The IPL treatment is not painful and requires no recovery time following the procedure. Patients report that the treatment itself feels like a rubber band being lightly snapped on the surface of the skin. Due to the minimal discomfort caused by the procedure, Dr. Green typically does not apply a topical numbing cream to the treatment area, as it is not necessary. Before the procedure, Dr. Green recommends that you do not use topical retinoids or use tanning beds, as a tan in the treatment area can disrupt the function of the IPL treatment. Dr. Green also recommends the use of sunscreen of at least SPF 50, to avoid unwanted sun exposure, following the procedure in addition to protective clothing.

Chemical Peels

Dr. Green employs a variety of proprietary chemical peels at her New York City office, which can be used to exfoliate and rejuvenate the skin, eliminating pigmentation such as liver spots and unclogging the pores. Using peels containing glycolic acid or trichloroacetic (TCA) acid, Dr. Green’s chemical peels are safe and effective at treating liver spots by gently exfoliating the outer layer of the skin. Removing the dead skin cells and pigmented cells triggers the production of new skin, which leaves you with more even, brighter and healthier looking skin. Chemical peels range in strength and composition and are adjusted in order to address different levels of discoloration caused by liver spots on various skin tones.

Cosmelan Peels

The Cosmelan chemical peel employs a proprietary combination of ingredients to eliminate discoloration and stimulate the creation of healthier skin. The Cosmelan peel is applied at Dr. Green’s office and left on for several hours – Dr. Green will determine the exact amount of time based on your treatment area – after which it can be removed at home with a gentle cleanser. The treatment will trigger an initial peeling, which will reduce the pigmentation on your face. Mild side effects of this process can include redness, scabbing, and dryness but Dr. Green may prescribe a gentle cleanser and rich moisturizing creams to address these mild side effects. Following the Cosmelan peel, Dr. Green may also prescribe topical serums and  creams from her MGSKINLABs, Inc. line of skincare products. These products will complement the Cosmelan peel, which includes hydroquinones, kojic acid, azelaic acid, among other proprietary ingredients. It is also imperative to use sunscreen and practice complete sun avoidance following the treatment.

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Cosmelan treatment – 6 weeks

Mesopeels

Mesopeels are chemical peels that are specifically designed to treat hyperpigmentation in sensitive areas. The Mesopeel works in the same way as other chemical peels: by gently exfoliating the skin, which removes dead skin cells and triggers the creation of new collagen for rejuvenated skin. Unlike the Cosmelan Peel which is left on the skin for several hours, Mesopeels are left on for a matter of minutes before being removed, and the amount of time applied varies depending on the treatment area. Following the Mesopeel procedure, Dr. Green may also prescribe lotions and creams from her MGSKINLABs line of products for the best and lasting results.

Skin Care Products – MGSKINLABs, Inc.

There are many over-the-counter products available for treating facial discoloration and pigmentation. However, there is a lot of confusion as to which products to use and for which skin tones. To this end, Dr. Michele Green has designed a complete line of products, including  skin lightening lotions and creams, to help improve skin tone, texture, sun damage, and liver spots. Dr. Green has also developed her own pigmentation program for patients to use prescription topical hydroquinone creams at home. The program combines retinol, to exfoliate the skin and promote cell turnover, Vitamin C Serum, which is a powerful anti-oxidant and skin lightening serum, with hydroquinone-free skin lightening creams to gently brighten the skin. Along with these products, Dr. Green may prescribe a gentle cleanser and rich moisturizers to keep you skin smooth and fresh and further promote the skin’s health and wellness.

Microdermabrasion

Similar to a chemical peel, micro-dermabrasion works to exfoliate the skin and promote the production of collagen to generate smooth, light, and rejuvenated skin. However, unlike a chemical peel, which uses a mask to exfoliate the skin, microdermabrasion treatment employs aluminum oxide crystals to gently remove dead skin cells and eliminate discoloration in the skin. Patients may require several treatments in order to receive the best cosmetic  results.

HydraFacials

A HydraFacial is a three-step process to rejuvenate the skin and remove pigmentation, as well as treat acne, acne scars, and redness, and is safe and effective for all skin tones. The process starts out with a gentle cleansing of the face, which removes dead skin cells and hydrates the skin. This first step can be performed with the MD Active-4-cleanser or a chemical peel. Next, Dr. Green will exfoliate the skin using a specially designed device, with vortex technology, to lightly suction the skin and remove the dead skin cells. Lastly, Dr. Green will apply serums and moisturizers, designed to hydrate the skin and promote cell turnover for healthy, fresh, clearer skin.

Microneedling with skin lightening serums

Microneedling is another treatment option available in Dr. Green’s office and is effective in eliminating liver spots and acne scars, as well as improving the texture of the skin. The procedure involves piercing the skin with tiny microneedles, which create a series of micro-injuries in the treatment area. The body reacts to the small wounds by producing new collagen, which leads to smoother, healthier, brighter skin. Microneedling can also be paired with the application of rejuvenating serums or Platelet Rich Plasma (PRP), which further stimulates the creation of collagen in the skin. The treatment itself is painless and Dr. Green applies a topical numbing cream in order to minimize any discomfort. For the best results, Dr. Green recommends receiving between 3 Microneedling treatments spaced approximately one month apart.

Are liver spots dangerous?

No. Liver spots themselves are not dangerous, they are only a cosmetic concern. However, signs of malignant melanoma, which are skin cancerous lesions, or melanin-rich lesions on the skin, can look similar to liver spots.  Malignant melanoma is the most serious type of skin caner and develops within the melanocytes themselves. Melanoma is induced by genetics, ultraviolet sun exposure, and UV radiation from tanning beds. The appearance of sun spots or liver spots are flat, mostly even in color and size and generally symmetric in appearance. Malignant melanoma lesions are characterized by the “ABCDEs” characteristics of melanoma. Generally, there is asymmetry, irregular borders, changes in color, diameter more than 6 millimeters ,and is evolving or changing over time (in either size, color, or shape). If you are concerned about the appearance of a new dark lesion on your skin, it is best to have it examined by an expert board certified dermatologist, such as Dr. Michele Green in New York City. Dr. Green will be able to ascertain if the lesion is a benign liver spot or a potentially dangerous skin cancer, and determine if a skin biopsy and other treatment is needed.

Do liver spots grow?

Liver spots develop as a result of repeated or extreme exposure to the sun’s ultraviolet rays. They form as a result of an increase of melanin production, which coalesce to a single location, creating a tan or brown spot. Once they have formed, however, they do not typically grow. If you notice an asymmetrical spot with irregular borders that is growing, shifting, getting darker, or changing, that could be a sign of melanoma, or skin cancer. If you are noticing changes in spots on your body, it is best to consult Dr. Green so she can make a determination about whether the spots are harmless liver spots or cancerous lesions.

How to treat age spots

Many patients wonder what is the best way to treat unwanted pigmentation, sun spots, and  liver spots. Dr. Michele Green has the most effective cutting edge chemical peels and laser treatments to remove unwanted age spots. When you schedule your consultation with Dr. Green, she will asses the treatment area to determine the severity and scope of the condition. From that determination, and taking into consideration your specific needs and aesthetic goals, Dr. Green will develop the treatment plan that is right for you. Your treatment plan may be a single treatment option or a combination of several treatments in order to achieve the best cosmetic results.

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What are liver spots on the face?

Liver spots are brown or tan, flat, round spots that develop in any area that has been exposed to extreme sunlight. The face is a common area for liver spots to develop, as the face is infrequently covered by protective clothing and therefore an area of the body that is often directly exposed to the sun. If you are often outside between the hours of 10am and 3pm, when the sun is at its most intense, and you have neglected to wear sun protection such as sunscreen, you may be at greater risk for developing liver spots on your face. Liver spots on the face can still be eliminated using any of the methods listed above, including laser therapy, IPL treatment, chemical peels, HydraFacials, microneedling, and using a combination of skin lightening creams and lotions containing kojic acid or tranexamic acid.

Why are liver spots called liver spots?

The origin of the name “liver spots” is not certain, though today we recognize the term as a misnomer. Liver spots, in actuality, have nothing to do with the function of the liver. Some say that the term “liver spots” arose because people used to think that the spots were related to the function of the liver. Others say that the name was given to the spots due to their liver-like color. Regardless, the name remains but can be used interchangeably with other terms such as sunspots or age spots.

How do I get started with sun spot/liver spot treatment today?

If you are tired of the appearance of sun spots, or liver spots on your face, or body, you can eliminate the dark spots safely and effectively at the Upper East Side dermatology office of Dr. Michele Green. Dr. Green will rejuvenate and improve your skin as a result of pigmentation from sun damage, freckles, sunspots, on the face or any other area of the body. With over two decades of experience in treating sun damage, and an expert in chemical peels and laser treatments, it is no wonder that Dr. Green is consistently voted as one of the best dermatologists in New York. To find out which cosmetic treatment would be best for you, please call us at 212 535 3088 or contact us online today.

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