Preventing Age Spots and Age Spot Removal

This article follows on from the article: Liver spots, Lentigo and Lipofuscin: What causes liver spots?

Can I do anything to prevent liver spots?

Prevention is always better than cure, and if you’re at a stage in your life where you don’t yet have liver spots (also known as age spots, sun spots or solar lentigo), you have a good chance of preventing them from occurring by doing the following:

1.) Protect yourself from the sun:
By minimizing sun exposure, wearing protective clothing and sunscreen with a broad-sprectrum UVA and UVB sun protection factor (SPF) of at least 15 on exposed skin, you will be reducing the risk of liver spots. Higher SPFs like 30, or ultraviolet protection factor (UPF) of 40 or 50 would be even better. A few sunscreens with more natural ingredients are:

If you’re out for several hours, reapplication of sunscreen may be necessary after about 2 hours in intense sunlight, especially if there is a lot of sweating going on that may be washing off some of the sunscreen.

The risk of sun exposure causing free radicals is greatest when the sun’s rays are most intense, and this is often between 10am and 4pm. Vigilance about sun protection is most important at these hours.

Other precautions you can take against the sun aside from sunscreen include:

• Hats: You can wear a broad-rimmed hat to protect your face from the sunlight.
• Anti-UVA films on windows: You can have anti-UV-A-film installed on your car windows to help minimize exposure when driving.

2.) Avoid products that increase skin sensitivity to the sun if you know you’re going to be out in the sunshine:

Some chemicals in food increase the skin’s sensitivity to the sun. These chemicals are called psoralens. Certain people are genetically predisposed to be sensitive to psoralens. You’d know if you’re sensitive to psoralens if you notice that you’re more prone to getting sunburned after eating certain foods. If you are one of these sensitive people, foods to avoid before going out into the sun include: figs, celery, parsley, dill, lime and other citrus fruits, and also the herbs, Angelica and St John’s wort.

3.) Eat a lot of antioxidants:
Age spots are strongly linked to free radical damage, so eating lots of antioxidants which help neutralize free radicals, is one tool for preventing age spots.

There are plenty of antioxidants to choose from which you can eat through food, or supplement if desired. Some of the main antioxidants for skin health include:

(a.) Vitamin E:
Vitamin E is a fat-soluble vitamin, and for this reason it the #1 antioxidant to protect fatty acids, which are the main contributors to lipofuscin liver spot production. Eating vitamin E-rich foods is great to help you get your antioxidant levels up.

If desired vitamin E can be supplemented with 200-400IU a day. At a dosage of 400IU, this supplement is recommended only in the short-term (i.e. for a couple of weeks or so) rather than the long-term (i.e. years and years). Studies have found possible links to heart problems in long-term vitamin E supplementation at doses of over 400IU. Short-term supplementation at this dose however, for example when on holiday and spending more time in the sun, could be useful. Good vitamin E supplements to use are those with mixed tocopherols rather than just alpha-tocopherol. A good brand of vitamin E is Solgar’s Natural Vitamin E (Mixed Tocopherols), 400 IU.
Please note: You should not supplement vitamin E if you are taking anticoagulant drugs.

Alternatively, a lower dose in a multivitamin in the long-term should be safe. Some good brands of multivitamins containing vitamin E are given below.

(b.) Alpha lipoic acid:
This is a potent antioxidant that’s only found in quite low levels in food. It is best supplemented, and a good brand is Metagenics’ Meta Lipoate 300, and a good dose would be two of these 300mg tablets a day (to get a therapeutic dose of 600mg). Lipoic acid also has other benefits including sugar balancing and improving energy production.

(c.) Vitamin C:
Vitamin C is one of the best known antioxidants and it has a role in making the skin’s collagen, so is an important skin-health nutrient.

It’s worth seeing which foods contain high vitamin C levels and incorporating more of these foods into your diet. Having said that, getting sufficient vitamin C from food is very difficult because vitamin C is very sensitive to destruction by heat and time exposed to air. This means that it’s often quite low in foods by the time you eat them. You can supplement with a vitamin C supplement that contains 500mg. Choose a brand of vitamin C in the “buffered” form of magnesium ascorbate, calcium ascorbate, or “mixed ascorbates”. Avoid forms that are “ascorbic acid” because these are acidic. Choose one that contains bioflavonoids, because these increase vitamin C absorption. A good vitamin C brand that meets these requirements is Solgar – Bio-Ascorbate Buffered Vitamin C Complex, 500 mg, .

(d.) Selenium:
Selenium is another antioxidant which also has a role in skin health. So it’s great to include some selenium-containing foods in your diet. If you have 1-4 Brazil nuts a day, that would be a good start.

(e.) Other antioxidants
The list of possible antioxidants can go on and on, and it includes also Zinc, carotenoids, reservatrol, polyphenols like OPC, anthocyanidins, curcuminoids, Epigallocatechin, EGCG and Quercetin to name but a few.

There is a measure of “antioxidant capacity” of foods which takes into consideration all these antioxidants together and measures the total antioxidant-effect of the food. This “antioxidant capacity” is known as ORAC (Oxygen radical absorbance capacity). You can find lists of antioxidant-rich foods organized by ORAC values which can be useful to check out.

You can get general antioxidant supplements containing several antioxidants in one tablet which can be helpful. Most multivitamins are rich in antioxidant molecules. Some good multis include: Nature’s Plus’ Nutri-Genic Softgels, which is iodine-free, or if you’re certain you have no autoimmune antibodies, you can go for an iodine-containing multi like Nature’s Plus’ Source Of Life Liquid , or Solgar’s Female Multiple . Please note that smokers should not use multis that contain beta-carotene because the interaction between smoking and this nutrient has been associated with increased risk of lung cancer.

Can I do anything to treat liver spots once I have them?

Unfortunately, once you have them, liver spots are notoriously difficult to shift naturally. Whilst there are the extreme options in allopathic medicine for treatment like skin bleaching, freezing the spots off, lasering them off or going for chemical peels, there are also milder treatment alternatives to try:

1.) Rosehip oil:
A study by Pareja et al (1988) entitled “Contributions to identification and application of active components contained in Rosa aff. rubiginosa”, found that spots faded upon application of rosehip oil for a minimum of 3 weeks. They write: “Significant changes were noted starting on the third week. Firstly, surface wrinkles started to disappear, spots started to fade until, at the end of the fourth month, the disappearance was complete. Skin presented a smooth and fresh aspect and the spots had almost disappeared.”

One brand of rosehip oil on the market is NZ Fusion Botanicals’ Pure Organic Rosehip Oil although there are several other brands available.

2.) Things that break down lipofuscin:
There are certain things that have been shown to break down lipofuscin deposits in various places in the body.
One drug that is used for this purpose is DMAE, although it has been reported to potentially have some minor temporary side effects (like headaches, insomnia and muscle tension), and is advised to be used with caution and medical supervision where epileptics are concerned. Some people who use DMAE for the removal of lipofuscin from their skin report that a daily dose of 300 mg (of 100% DMAE) causes the disappearance of liver spots after a few months. Other researchers report that a minimum of 1,600mg per day is required for this purpose. I would recommend medical supervision if going down this route. A few examples of DMAE cream on the market include derma e Retexturizing Creme, DMAE- Alpha Lipoic – C-Ester , DMAE skin cream , and Perricone MD High Potency Evening Facial Repair; but I would advise consulting a dermatologist for picking a product with the right dosage of DMAE in it.

There are other reports of certain nutrients helping to break down lipofuscin in areas of the body such as the brain (eg. Acetyl-L-Carnitine and many of the antioxidants mentioned above). However more research is needed to find out if these work on skin lipofuscin.

3.) Glycolic acid:
Glycolic acid is actually one of the acids used in acid-chemical peels when at high concentrations, but it can be bought at low concentrations over the counter and is said to be effective in helping liver spots fade when applied topically. Although it is one of the gentler, “light” chemical peels, it is still a peel, so if you’re going down this route, personally I think you really ought to be under supervision of a skin specialist because if not carried out at the right, safe concentrations, glycolic acid can burn the skin. One example of a glycolic cream on the market is Reviva – 10% Glycolic Acid Night Cream .

4.) Retin-A:
Like glycolic acid, retin A, also known as retinoic acid, is used in chemical peels when at high concentrations, but is available in lower concentrations as a prescription-cream. Treatment duration depends on the individual, but benefits can be seen within about a month for some people, or after 10 months for others. There are several creams available but 0.025% concentration is said to cause less irritation than the stronger concentration creams.

The problem with retin-A is that it does irritate the skin, causing redness, dryness, peeling, or even blisters initially, although these effects are said to decrease with ongoing use. The idea of how retin-A works is that it peels away the old skin to reveal new, liver-spot-free skin underneath. One side effect that does not diminish is the fact that retin-A makes the skin sensitive to sunlight, so that you are more prone to sunburn if you are unprotected in sunlight.
Retin-A is also potentially dangerous in pregnancy where too much retinoic acid may harm the baby.

Again, I would definitely advise seeking professional advice before using strong chemicals like this.

The Integrative Medicine specialist, Dr Andrew Weil, recommends the drug Retin-A as a tried and tested way of fading liver spots. (You can see his article on this topic here). As a side-benefit, retin-A also helps reduce wrinkles and other blemishes.

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