Also termed “flowers in the land of the dead,” black spots on the face are generally referred to as seborrheic keratosis or senile lentigo, and are gradually formed as the skin ages. There are many people who think that black spots on the face occur only in old age. But they can also occur in younger people who frequently perform outdoor activities and are exposed to ultraviolet rays.

The signs of skin aging such as black spots or wrinkles progress because of the natural aging process or the effects of photo-aging due to UV exposure. Of the two factors, photo-aging is more significant. UV rays damage the collagen and elastic fibers that support the epidermis, which leads to the formation of wrinkles. This might also lead to the occurrence of black spots or skin cancer. Fair-skinned people are more susceptible to sun damage because their melanocytes have less of a skin-protecting effect.

Black spots are commonly noted on body areas exposed to the sun, including the face, back, backs of the hands, arms and legs, where they occur with a rounded or elliptical shape or in a protruded form. In particular, a high presence of black spots on the face suggests that individuals have a type of skin with an increased risk of skin cancer. This deserves special attention. In addition, in adult cases of sudden pruritis in which many black spots are concurrently present, the symptoms might originate from internal malignancy. This should therefore be checked by clinicians.

Black spots can be treated using such methods as electrosurgery, dermabrasion (peeling) and laser therapy in dermatologic clinics. Dermabrasion is a procedure where the skin surface is burned with chemical peeling agents and then peeled away. Skin laser therapy is the most effective treatment, but it may also cause several side effects depending on the characteristics of the black spots or type of skin. Prospective patients should first consult with board-certified specialists in laser therapy. Furthermore, several types of skin whitening ointment can also be used and are effective to some extent. But they are disadvantageous in that they take a longer time to work.

It is natural to want to look younger, but aging is unavoidable. We can, however, maintain our skin if we pay some attention to it. This is not only because black spots on the face and wrinkles can be prevented to some extent by inhibiting the photo-aging process with the use of UV blockers but also because retinoid, dermabrasion and laser therapy are effective at rejuvenating aged skin. 

By Dr. Lee, Dong-Yoon

The author is a professor of Sungkyunkwan University School of Medicine and doctor at Department of Dermatology of Samsung Seoul Hospital. ― Ed.