Liver spots are flat, brown or black spots that can appear on areas of the skin exposed to the sun. They have nothing to do with the liver or liver function.A.D.A.M.

Causes, incidence, and risk factors

Liver spots are changes in skin color that occur in older skin. The increased color may be due to aging, exposure to the sun or other sources of ultraviolet light, or causes that are not known.

Liver spots are very common after age 40. They occur most often on areas that have had the greatest sun exposure, such as the:

• Backs of the hands
• Face
• Forearms
• Forehead
• Shoulders

Symptoms

 Liver spots appear as a patch or area of skin color change (macule) that is:

• Flat
• Light brown to black in color
• Located on the hands, arms, or forehead
• Painless

Signs and tests

Your doctor will diagnose the condition by how the skin looks, especially if you are over 40 and have had a lot of exposure to the sun. You may need a skin biopsy to confirm the diagnosis if a liver spot that looks irregular.

Treatment

No treatment is needed in most cases. You can improve the appearance of your skin by using skin bleaching lotions or creams. Most bleaching lotions use hydroquinone. This medicine is thought to be safe in the form used to lighten darkened skin areas. However, hydroquinone can cause blisters or skin reactions in some people. See your health care provider before starting treatment if you are worried.

Freezing (cryotherapy) or laser treatment can be used to destroy the liver spots.

Expectations (prognosis)

Liver spots are not medically dangerous. They are permanent skin changes that may affect the cosmetic appearance of the skin.

Calling your health care provider

Call your health care provider if:

• You have liver spots and want them removed
• You develop any new symptoms, especially changes in the appearance of a liver spot

Prevention

Protect your skin from the sun by taking the following steps:

• Cover your skin with clothing such as hats, long-sleeved shirts, long skirts, or pants.
• Use sunglasses to protect your eyes.
• Try to avoid sun exposure at midday, when sunlight is strongest.
• Use high-quality sunscreens that have an SPF rating of at least 30. Apply sunscreen at least a half hour before you go out in the sun. Reapply it often. Use sunscreen in the winter, as well.

References

1. Rabinovitz HS, Barnhill RL. Benigh Melanocytic Neoplasms. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al, eds.Dermatology. 3rd ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 112.
2. Habif TM. Light-related diseases and disorders of pigmentation. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 19.

Review Date: 11/20/2012.

Reviewed by: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.