Age spots in your 50s: will brightening products fade them?

Brown spots that multiply on the face and the backs of the hands in your 50s may not be melasma, which spreads symmetrically across both cheeks. They may be sharply bordered solar lentigines (sun spots) or raised seborrheic keratoses. Raised spots are a job for a dermatology procedure; for flat spots, start with sun protection.

Among Korean men, 93.9% of those in their 50s had seborrheic keratoses, and relative to skin area the face and the backs of the hands carried the most (Kwon et al., 2003).

Spots in your 50s: how to tell melasma, sun spots and seborrheic keratoses apart

A solar lentigo is a flat, sharply bordered brown spot on skin that has had years of sun (DermNet, 2024). A seborrheic keratosis starts as a rough bump, thickens over time and looks stuck on to the skin (American Academy of Dermatology). Melasma spreads broadly and symmetrically across both cheeks and the forehead (Ogbechie-Godec et al., 2017).

If it is raised and feels bumpy under your fingertip, it is a seborrheic keratosis; if it is flat and sharply bordered, a solar lentigo; if it spreads symmetrically over both cheeks, melasma. A solar lentigo can be slightly raised, though, and a flat brown spot can be confused with lentigo maligna (melanoma in situ), so the final call belongs to a dermatologist (DermNet, 2024).

Can brightening products clear sun spots and seborrheic keratoses?

The American Academy of Dermatology notes that seborrheic keratoses are harmless and do not need to be removed, and that removal is a dermatology procedure. Removing a solar lentigo also takes a dermatology procedure or a doctor's prescription (DermNet, 2024).

We found no evidence that brightening products clear seborrheic keratoses, and no study that tested cosmetic brightening ingredients such as niacinamide on solar lentigines alone. A cream with 2% niacinamide and 2% tranexamic acid reduced uneven facial pigmentation significantly more than the same cream without the actives, but lentigines were not diagnosed and analysed separately (Lee et al., 2014). So try brightening ingredients on flat spots only, and leave seborrheic keratoses out of it. How each ingredient works is in Brightening ingredients: what actually fades pigment?

Why does sun protection come first for spots in your 50s?

Solar lentigines and seborrheic keratoses are both linked with cumulative UV exposure. Among Korean men, those with a lifetime average of 6 or more hours of sun a day had 2.28 times the risk of having six or more seborrheic keratoses compared with those under 3 hours (Kwon et al., 2003). Sun protection works on new spots; we found no trial showing that sun protection or brightening ingredients such as vitamin C or tranexamic acid faded spots that were already there. So put sun protection first, and expect brightening ingredients to even out overall tone only a little (DermNet, 2024).

In short, spots that look alike can be different spots, and sun protection is the shortcut for keeping every kind from forming

Protect your face and the backs of your hands from UV every day, and leave raised spots alone rather than trying to lift them off with brightening products or exfoliation. Seborrheic keratoses are common, 9.2 per man in his 50s, and harmless (Kwon et al., 2003), but they can look like skin cancer, so a spot that is new, keeps changing shape, itches or bleeds calls for a dermatology visit before any procedure (American Academy of Dermatology).

One step today

• In bright window light, run a fingertip over each spot one by one, then compare both cheeks in the mirror. If you want a raised, bumpy spot removed, that takes a dermatologist's procedure rather than a brightening product (American Academy of Dermatology). A cream with niacinamide and tranexamic acid can even out facial tone a little around flat spots (Lee et al., 2014, not a lentigo-only trial), but if you want a flat spot removed, that too takes a dermatology procedure (DermNet, 2024).
• Every morning, apply sunscreen to your face in two layers and take it down to the backs of your hands. Solar lentigines and seborrheic keratoses are both linked with UV (Kwon et al., 2003 · DermNet, 2024). For how much to use, see Sunscreen — how much is actually enough? Afterwards, check in the mirror for under-covered patches on the backs of your hands and beside the cheekbones.
• Look for any spot that is new or keeps changing shape. Check whether a single spot mixes several colours, whether its border is blurred, and whether it is wider than 6 mm (American Academy of Dermatology). Comparing against a photo taken in the same light makes changes easier to see. If you find one of these, or a spot itches or bleeds, see a dermatologist without waiting.