Liver spots

Liver spots are changes in skin color that occur in older skin. The coloring 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

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

• Flat
• Light brown to black
• Painless

Your health care provider usually diagnoses the condition based on how your skin looks, especially if you are over 40 and have had a lot of sun exposure. You may need a skin biopsy to confirm the diagnosis. The biopsy also helps rule out a skin cancer called melanoma if you have a liver spot that looks irregular or is unusual in other ways.

Most of the time, no treatment is needed. Talk to your provider about using bleaching lotions or creams. Most bleaching products 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 sensitive people.

Talk to your provider about other treatment options, including:

• Freezing (cryotherapy)
• Laser treatment
• Intense pulsed light

Liver spots are not dangerous to your health. They are permanent skin changes that affect how your skin looks.

Contact your provider if:

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

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.
• Try to avoid the sun at midday, when sunlight is strongest.
• Use sunglasses to protect your eyes.
• Use high-quality broad-spectrum sunscreens that have an SPF rating of at least 30. Apply sunscreen at least 30 minutes before you go out in the sun. Reapply it often. Also use sunscreen on cloudy days and in the winter.

Sun-induced skin changes - liver spots; Senile or solar lentigo or lentigines; Skin spots - aging; Age spots

Dinulos JGH. Light-related diseases and disorders of pigmentation. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 19.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Melanocytic nevi and neoplasms. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 30.

Updated by: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.