Skin Republic

Dear Dr. Jen,

What factors bring on age spots sooner?  What can be done to eliminate them?

45 year old male

Dear Sir,

There are two kinds of conditions often labeled as “age spots”.  The first one is solar lentigo.  Solar lentigos or sun spots are simply very large freckles.  They are brought about by a lifetime of constant sun exposure.  It doesn’t matter if you’ve been un-exposed to the sun in the past five years of your life.  The fact is you were exposed in your childhood up to five years ago and this will manifest on your skin at about the age of 50. It also doesn’t help that we are a country that lies very close to the equator with UV rays hitting us even while we are indoors.

The second kind of age spots are the seborrheic keratosis or liver spots.  These are thickened, very dark brown or black elevated papules on the face, neck, and arms.  These are often mistaken as warts or moles.  Ageing, sun exposure, and genetics can bring about seborrheic keratosis.

Religious use of sunscreen with an SPF of 30 or higher will help prevent early onset of age spots.  Daily sunblock while indoors or even while in the car can go a long way too.  For Filipinos, finding a matte and non-greasy sunscreen is the holy grail. There are three particular sunscreens (Sunskeen, VMV and Gel Sunblock) that I am partial to because it fulfills the non-greasy and non-stinging criteria. Plus you don’t form beads of sweat after you apply it.  It is truly a matter of finding the right brand for you.  Sometimes you can get these brands at your favorite PDS derma.  Additional application of tretinoin can also be beneficial in delaying the appearance of sunspots and seborrheic keratosis. So start today in looking for the sunscreen that best suits your skin type!

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Dear Dr. Jen,

I had warts on my neck cauterized several years ago which resulted in bumpy scars.  I went to the mall salon to have it removed. Up to now, the skin still hasn’t gone back to normal.  Can anything be done about it? 

Gabby

Dear Maya,

Neck scars are especially difficult to hide when you can’t wear turtlenecks or scarves in a tropical country. Cautery is easy enough for anyone to perform.  When the person doing the removal of warts isn’t familiar with the anatomy and histology of the skin, the tendency is to go deeper than necessary when performing cautery.  But the tricky part is knowing which setting to use and how deep you must go to take out different kinds of lesions.

Fortunately, you can still go to a PDS dermatologist to remedy the hypertrophic scars. The fastest way to go about flattening and shrinking the scars is to do intralesional injections (under a cream anesthesia of course!). You may also have laser done, though it may take forever and is definitely much pricier than the injection.  I hope you will soon be rid of the unbecoming neck scars!