What treats solar lentigines (sun spots)?

From the Guidelines

Solar lentigines, commonly known as sun spots or age spots, can be treated with several effective options, including topical treatments and in-office procedures, with prevention being crucial to prevent new spots from forming and protect treated areas. To treat solar lentigines, topical treatments such as hydroquinone (2-4%), retinoids like tretinoin (0.025-0.1%), and azelaic acid (15-20%) can be used, as they inhibit melanin production, increase cell turnover, and reduce pigmentation 1. Some key points to consider when treating solar lentigines include:

• Topical treatments should be applied as directed, with hydroquinone used once or twice daily for 8-12 weeks, and retinoids used nightly.
• In-office procedures such as chemical peels, laser therapy, cryotherapy, and microdermabrasion can be effective for more stubborn spots.
• Prevention is crucial, with daily use of broad-spectrum SPF 30+ sunscreen, wearing protective clothing, and avoiding peak sun hours recommended to prevent new spots from forming and protect treated areas 1. It is also important to note that while sun avoidance and sunscreen use can help prevent skin cancer and early skin aging, there is no direct evidence that these measures can treat existing solar lentigines 1. However, prevention and treatment of solar lentigines should be prioritized to improve quality of life and reduce the risk of skin cancer and early skin aging.

From the FDA Drug Label

HYDRO-Q is formulated for the treatment of dyschromia The hydroquinone (TOP) may treat solar lentigines (sun spots) as it is used for the treatment of dyschromia.

• It should be applied to the affected areas twice daily, morning and before bedtime or as directed by a physician 2.
• Sunscreen use is an essential aspect of hydroquinone therapy because even minimal sunlight sustains melanocytic activity 2.
• To prevent repigmentation during treatment and maintenance therapy, sun exposure on treated skin should be avoided by application of a broad spectrum sunscreen SPF 15 or greater) or by use of protective clothing 2.

From the Research

Treatment Options for Solar Lentigines

There are several treatment options available for solar lentigines, including:

• Topical therapies, such as combination topical therapy using 2% mequinol/0.01% tretinoin [ 3 ]
• Chemical peels, which can be used alone or in combination with topical therapy [ 3 ]
• Cryotherapy, an effective and inexpensive treatment option [ 3 ]
• Intense Pulsed Light (IPL) and lasers, which are more costly treatment options [ 3 ]
• Q-switched ruby laser, which has been shown to be effective in treating solar lentigines with significant clinical improvement and low risk of adverse effects [ 4, 5 ]

Efficacy of Treatment Options

The efficacy of different treatment options for solar lentigines has been compared in several studies, with results showing that:

• Combination-based treatments have the greatest frequency of complete response (65%) [ 6 ]
• Laser-based treatments have a complete response rate of 43% [ 6 ]
• Topical retinoids have a complete response rate of 21% [ 6 ]
• Cryotherapy has a complete response rate of 15% [ 6 ]
• Chemical peels have a complete response rate of 6% [ 6 ]

Adverse Events

Adverse events have been reported with different treatment options, including:

• Topical retinoids, which have the highest rate of adverse events (82%) [ 6 ]
• Combination-based treatments, which have an adverse event rate of 39% [ 6 ]
• Cryotherapy, which has an adverse event rate of 33% [ 6 ]
• Laser-based treatments, which have an adverse event rate of 23% [ 6 ]
• Chemical peels, which have an adverse event rate of 19% [ 6 ]