Your concern
Age spots on the hands
Hands age before the face, because nobody puts sun cream on them.
The back of the hands is one of the most exposed surfaces of the body and one of the least protected. People who apply sunscreen to the face every morning almost never extend it to the hands — which are nonetheless on the steering wheel, on the table, outside the sleeve all year round. The result is that hands show sun damage before the face, and the brown spots appearing after forty are its most visible expression.
These spots — solar lentigines — are flat, brown, with fairly sharp borders, and accumulate over time on the backs of the hands, the forearms and the chest. They are benign, and treatable.
Two points, though, change the approach. First: at this site medical assessment comes before cosmetic treatment, because the back of the hands is also a typical site for lesions related to chronic sun damage, and a spot behaving differently from the others should be examined, not lightened. Second, and this is the real practical message: any treatment of existing spots is short-lived if the hands keep catching sun unprotected. Sunscreen on the hands, every day, is worth more than any session.
A spot that does not resemble the others gets examined
It is the same criterion that applies to moles, and on the backs of the hands it makes the same sense. A person's solar lentigines resemble one another: flat, brown, uniform. The one that stands out deserves a look — changing in shape or colour, becoming rough to the touch, developing a small crust that comes and goes, or growing while the others stay still. This site has been sun-exposed for decades, and that is precisely why looking should come before lightening: a cosmetic treatment on a lesion that was not a lentigo removes it from view without resolving it.
How it shows
- Flat brown spots on the backs of the hands
- Fairly sharp borders, uniform colour
- Progressive increase in number with age
- Appearance also on the forearms and chest
- Darkening after summer exposure
- Thinner skin on the back of the hand, with more visible veins
How we proceed
- 1Dermatological visit with dermatoscopic examination of the lesions
- 2Distinction between solar lentigines and other lesions at the same site
- 3Assessment of overall sun damage on the backs of the hands
- 4Treatment of the spots once the picture is clear
- 5Daily sun protection as part of the result, not an accessory
Available treatments
- Dermatology visit
- Dermatoscopic diagnosis
- Treatment of the spots
- Daily sun protection
Book a visit
Our specialists will evaluate your case and define the most suitable treatment plan.
Book in FlorenceBook in SienaSiena · Firenze
Frequently asked questions
Why do hands age before the face?+
For two reasons that add up. The first is exposure: hands are uncovered all year, including winter and while driving, and receive radiation continuously. The second is protection: almost nobody extends to the hands the sunscreen they apply to the face. Add to this thinner skin with less supporting tissue, which makes both spots and volume loss more visible.
Do over-the-counter lightening creams work?+
On established solar lentigines the effect is usually modest, because the pigment is deposited deep and the skin on the back of the hand is poorly permeable. What really counts is the combination of appropriate treatment and constant protection: without the second, any result is undone by the following season. This is why sun protection is presented here as part of the treatment and not as an add-on.
Do they come back after treatment?+
Treated lesions usually do not reappear in the same place, but the tendency to form new ones remains and depends on future exposure. In practice: the result lasts to the extent the habit changes. Anyone who treats the spots and goes on exposing their hands unprotected will see others appear, and that will not be a failure of the treatment but the continuation of the cause.
Related reading
Have a question? Let's talk.
Book a first visit: the physician will evaluate your situation and guide you to the most suitable treatment.
Book a dermatology visit