Everything You Need To Know About The Lentigo

As we age, dark spots appear on our skin , especially in the areas of the skin that have been most exposed, such as the face or hands.

It may look like you’ve got a freckle, but you actually have a lentigo .

Is it the first time you see this word? You are not the only one. Very few people really know what lentigo is, and therefore how to best treat it.

And for that we are here, we are going to tell you everything you need to know about lentigo. Keep reading!

What is a lentigo?

A lentigo is a flat or slightly raised pigmented lesion with a clearly defined border. It looks a lot like a freckle, but unlike a freckle, it doesn’t fade in the winter months.

The name lentigo originally referred to its appearance resembling a small lentil.

This injury can affect both men and women of all ages and races, although they are especially common in fair-skinned adults.

And its appearance can be sudden , almost overnight; or gradual , increasing in size and color over time.

They can develop singly, or more often, multiple. Most lentigos are less than 5 mm in diameter.

There are several types of lentigos, and they differ depending on their appearance, where they appear on the body, the causative factors, and whether they are associated with other diseases or conditions.

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Types of lentigo

Simple

It is the most common. They usually appear a few months of age or in childhood , and the spots can fade over time.

You will see the spots appear more commonly on the trunk, arms and legs. These have a diameter of 5 to 15 mm .

They differ from solar lentigines in that they appear at a younger age and on skin not exposed to the sun.

Solar lentigo

As its name suggests, it is produced by UV radiation from the sun , and that is why it occurs in areas exposed to the sun continuously, such as hands, face, legs, shoulders, etc.

This radiation causes melanocytes (pigmented cells) to multiply. And its size can slowly expand to several inches in diameter over time.

The most common is that mature people, over 40 years old , suffer from it , although they can also appear in younger people who have abused the sun.

Solar lentigines are sometimes called liver spots or age spots . The color can vary from yellow-brown to black.

Reticulated black lentigo

Also known as “ink spot” lentigo, this particular type appears after a sunburn , especially in very light-skinned individuals.

They are few in number compared to solar lentigines, and can be confused with melanomas .

The stain is patchy and dark brown to black in color, like an ink stain.

PUVA Lentigo

Similar to lentigo reticular, but develops after the start of treatment with psoralen combined with ultraviolet A (PUVA), which is used to treat conditions such as eczema and psoriasis.

Macules are usually 3 to 8 mm in diameter and persist for 3 to 6 months after treatment ends.

They also have a larger star shape (which can be up to 3 cm in diameter) that can persist for two years or more.

By radiation

It occurs in areas that have been exposed to radiation (accidental or therapeutic), for example from cancer treatment.

Lip and oral melanotic macula

It appears on mucosal surfaces or adjacent skin, such as the lower lip . The oral lesions occur in the gingival and buccal mucosa, palate and tongue.

They are light brown to dark brown in color, and it is also often called mucous melanosis.

Genital lentigo

In men, this can present as a tan or dark brown macula anywhere on the glans, shaft, or crown. They can reach a size of 15 mm.

In women, lentigos can occur anywhere on the genital mucosa and are usually between 5 and 15 mm in size.

There are also several diseases associated with lentigo:

• LEOPARD syndrome (multiple lentiginosis)  – lentigos, electrocardiographic conduction defects, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, growth restriction, deafness.
• Peutz-Jeghers syndrome – gastrointestinal polyps and pigmented macules.
• Laugier-Hunziker syndrome – a variable number of pigmented macules that usually appear around the oral mucosa or lower lip and in other areas.
• Myxomas – a group of disorders that include:

– LAMB – lentigos, atrial myxomas, mucocutaneous myxomas and blue naevos.

– NAME – naevos, atrial myxoma, myxoid neurofibroma and epellids.

– Carney syndrome – cardiac, skin and mammary myxomatous masses; lentigos; blue nevi; endocrine disorders; testicular tumors.

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What causes it?

The most common cause is exposure to ultraviolet radiation:

• Sun damage, including sunburn
• Solariums
• Phototherapy, especially photochemotherapy (PUVA)
• Ionizing radiation, for example radiation therapy, can also cause lentigos.
• Genetic heritage

How is it diagnosed?

Lentigos are usually diagnosed clinically by their characteristic appearance .

And since it is sometimes difficult to differentiate a lentigo from a skin cancer melanoma, the dermatologist may perform a dermoscopy or biopsy to ensure the diagnosis.

Lentigo treatment

Although it is not a worrying condition with regard to health, and if it is not treated absolutely nothing happens; the truth is that most people tend to want to remove or diminish their appearance for aesthetic reasons.

These different approaches are often used to lighten these spots:

• First, the daily use of a broad spectrum sunscreen with SPF 50+ in any area that is exposed to the sun. Find here the best sunscreens on the market .
• A lightening or depigmenting cream can then be used that contains an ingredient proven to minimize the appearance of blemishes, such as hydroquinone, kojic acid, azelaic acid, arbutin , etc. Here are the best options on the market .
• The use of chemical peels with Alpha hydroxy acids can help even out the tone and minimize the darkening.
• The creams with antioxidants such as vitamin C and retinol are also a good way to maintain the achieved results, and prevent them from coming back, or re-pigmenting again lentigines.
• Cryotherapy (freezing to destroy melanocytes), laser or pulsed light therapy (to destroy melanocytes) therapies also usually work very well. One study found that cryotherapy was more effective than 40% trichloroacetic acid for treating solar lentigos, although the difference was not significant.

However, you should keep in mind that these aggressive therapies are effective in the treatment of solar lentigos but carry the risk of post-inflammatory hyperpigmentation.

How to prevent it

Basically, if you want to avoid solar lentigo, you should use a broad spectrum sunscreen with an SPF of 30 or higher every time you go outside, especially during the sunniest hours, between 10 a.m. and 2 p.m.

Remember that you must reapply it every 2 hours if you continue to be exposed to renew its effectiveness.

In addition, it is always a good idea to cover up with hats and clothing when we are in direct sunlight.

You should also avoid excessive use of solariums and tanning beds , as well as a single dose of ionizing radiation.

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Conclusion

Lentigo is usually harmless, however, aesthetically it is usually very annoying. And with age and sun exposure, they increase in number.

So the best defense in prevention. Always wear sunscreen and a hat and sunglasses when going outside.

If it still persists or they come out more, you can treat them with specific treatments and creams to depigment the skin.

Reference sources:

Lentigo – DermNet NZ

Lentigines – American Osteopathic College Of Dermatology

Age Spots – American Society for Dermatologic Surgery

Comparative study of treatment efficacy and the incidence of post-inflammatory hyperpigmentation with different degrees of irradiation using two different quality-switched lasers for removing solar lentigines on Asian skin . – J Eur Acad Dermatol Venereol.