by Harvey Abrams, M.D.

AGE SPOTS AND DISCOLORATION OF SKIN due to sun damage provides an excellent opportunity to educate clients about treatment options and begin treatments at the spa. If spa clients often complain that they hate the way their hands look, take advantage by providing products and services to treat the condition and create revenue for the spa.

The splotches on the back of the hands commonly are known as liver spots, although they have no connection to the liver. They are due to prolonged exposure to ultraviolet light. Also called age spots and sun spots, these permanent discolorations of skin are caused by years of accumulated sun exposure.

The spots begin appearing on the skin after age 40. It is estimated that 90 percent of women over the age of 60 have one or more of these sun spots. Age spots provide an excellent opportunity to educate clients about treatment options, suggest products and services, and start their treatment right there and then in the spa.

Many women are concerned by age spots when they appear. The spa’s first course of action is to help clients identify the problem and reassure them that although sun spots are caused by sun exposure, they are benign and no cause for worry.

Age spots vary in color from tan to dark brown, in size from a small dot to the size of a quarter, and in number from one to dozens, sometimes covering most of the back of the hand and forearms. Medically known as solar lentigines, they usually are flat but sometimes feel slightly elevated and rough on the surface.

Although they may look similar to moles, age spots are very different. Moles are genetically predetermined, while age spots are the result of sun exposure throughout life. The color (tan to brown) is due to the sun’s ultraviolet rays over time, causing an increase in the number of pigment-producing cells of skin known as melanocytes.

Melanocytes produce melanin, which determines the skin’s color. The more melanocytes and melanin produced, the darker the color of the sun spots. The good side to these unsightly blemishes is that they have no chance of becoming skin cancer. They also are preventable and treatable.

The only way to prevent age spots is to use sunblock and wear protective clothing before the age of 40. An ounce of sunblock prevention is worth a pound of cure.

Effective treatments do exist to remove or lighten spots, but additional sun exposure will cause the spots to return. It’s essential to protect the skin against new age spots and prolong the result of treatment by wearing sunblock on all exposed areas of the body every day, even in winter.

Women should get into the habit of applying sunblock on their hands every morning and carrying a small tube of sunblock to reapply after hand-washing. It is an excellent idea for the skin professional to end a treatment by massaging sunblock onto the back of clients’ hands and educating them about the importance of using sunblock. If the spa does not offer purse-size tubes of hand sunblock as retail items, it is missing an excellent opportunity to help clients and its bottom line.

There are several over-the-counter and doctor-prescribed treatments to remove age spots. Most treatments do not act quickly. Just like nails, it takes time for the skin to replenish itself.

Fade Creams: Many over-the-counter products are available to lighten skin. A common bleaching agent is 2-percent hydroquinone, as is vitamin C and vitamin A in the form of retinol. These creams gradually will lighten age spots and even out skin tone over a couple of months.

Retinoids: Prescription-strength vitamin-A creams such as RETIN-A and RENOVA will fade discoloration while stimulating growth of new, healthy cells. They sometimes are used with prescription-strength bleaching creams for a stronger bleaching effect. Retinoids can be drying and harsh for some skin types, require a trip to the doctor’s office and take two to three months to see results.

Chemical Peels: Dermatologists have developed a variety of liquids known as chemical peels that effectively smooth and firm skin and gradually lighten age spots. The peel treatment can be done during a lunch hour and there is no recovery time. A series of several peels done once every week or two are required for optimal results.

Laser: Lasers also can remove most traces of age spots and discoloration, usually in one treatment. Laser treatments are expensive, often painful and usually require more than one trip to the doctor’s office.

The combination of chemical peels, bleaching creams and sunblock is a highly effective and economical treatment for age spots. Professional hand-peel kits are available and allow spa professionals to offer clients the same safe and effective treatment performed in dermatologists’ offices. Where a dermatologist would charge $250- $300 per treatment, skin professionals can offer these treatments for $45-$95.

Hand peels usually are done in a series of four to six treatments performed at regular two-week intervals. For optimal results, clients also should be sold a bleaching cream to use each night and a sunblock to wear during the day.

Adding these treatments and products to the spa’s menu raises the level of the spa’s services, distinguishes the spa from the crowd and keeps satisfied clients coming back.

Harvey Abrams, M.D., is the founder and medical director of SKINSKIN, Inc., with a private practice at Wilshire Aesthetics in Los Angeles. Abrams is recognized as one of the world’s leading experts in cosmetic dermatology. For more information, visit www.wilshireaesthetics.com or www.skinskininc.com.

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