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What is That....? Benign Skin Changes with Aging

It is not unusual to see changes in skin over time. Dark spots become more prevalent and increase in size, moles develop and change, small red spots may appear. It is important to have a skin examination yearly to assess any questionable lesions. Most of the changes are benign and a result of genetics, aging, and sun exposure.

Skin changes associated with sun exposure tend to be located on the face, upper shoulders, arms, and hands. Freckles (flat, tan round spots) multiply and may become darker. Some fade in the winter and become more noticeable in the summer. Sunburn freckles tend to be larger, darkerm and may have irregular borders. They have been referred to as lentigines. Larger freckles have been referred to as liver spots. Liver spots are large flat dark areas often located on the back of the hands. They are not related to any liver disease but rather are the result of genetic predisposition and sun exposure. Freckles are not dangerous but repeated sun exposure is very damaging to the skin. The best treatment is to limit sun exposure. Larger spots can be minimized with bleaching creams or treated with laser therapy.

Raised rough bumps on the skin are called seborrheic keratoses. They are usually tan or brown but can be any color. They are more frequently located in sun exposed areas and become more numerous with age, as if they were spreading. They are not contagious or spreading; there are just more of them with age. They are not dangerous but are often removed for cosmetic reasons.

Small rough spots often seen in areas of the body with chronic sun exposure are called actinic keratoses. They are reddish in color and may appear to have a thin layer of transparent or yellow skin over them. They can be irritated by rubbing and may become sore. Actinic keratoses are considered precancerous lesions although it can take years, if ever, for squamous cell skin cancer to occur. They can be treated with prescription medication or removed.

Red or purple spots often develop in the skin after age forty. They are cherry angiomas and are about the size of the head of a pin. They may be flat or slightly raised and are the result of an overgrowth of small blood vessels. Spider angiomas may also be present. They are a group of tiny blood vessels seen under the skin. Cherry angiomas and spider angiomas are not dangerous but can be distressing, based on location and size. Fortunately, they can be treated with laser therapy. It is important to distinguish cherry adenomas from petechiae (small, round spots caused by small broken blood vessels that appear similar, but often darker and closer together) which can be a symptom of a serious illness. Your doctor will be able to tell the difference.

Genetics and sun exposure contribute to skin damage and change. Many skin changes are not health threatening but can become more serious over time. Skin should be examined at least annually. Any lesion that bleeds, changes color, becomes larger and more irregular should be addressed with your health care provider. Limit sun exposure with clothing and frequent sun screen. Apply sun screen to exposed skin even in the winter. Sun damage occurs over time with even the smallest exposures.

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