Q. How do I remove liver spots from my face? A friend says that you can use a bleaching cream for this. Is one available over the counter, or do I need a prescription?
A. Liver spots, as they're called, have nothing to do with your liver. Instead, these flat brownish spots result from years of sun exposure. They're bigger than freckles and appear in fair-skinned people on sun-exposed areas such as your face, hands and arms.
The medical name for them is solar lentigo (solar refers to the sun, and lentigo refers to a lens-like shape). They're also called "senile" lentigo (plural, lentigines), not because you're getting senile, but from the Latin word for old. Another name is age spots. Because they're a form of skin damage from lots of sunshine, you also might have wrinkling, dryness, thinning of the skin and rough spots called actinic keratosis nearby.
Age spots are a cosmetic concern, and not something that otherwise needs treatment. If you want to lighten these spots, you have several options:
* Lightly freeze them for several seconds, using cryotherapy applied by a physician.
* Use laser therapy (although this may be expensive).
* Apply skin-lightening creams. You can use 2 to 4 percent hydroquinone cream two or three times a day for several weeks to months. These come in prescription (4 percent) and nonprescription (2 percent) strengths. Examples are Eldopaque, Eldoquin, Esoterica, Porcelana and Solaquin.
You should also use sunscreens or sun blocks to keep the skin from darkening. If you wear makeup, an opaque kind provides extra protection. Examples include Clinique Continuous Coverage and RV Paque. Some hydroquinone creams come in an opaque form, such as Eldopaque and Eldopaque Forte, or combined with sunscreen, such as Solaquin. Or, you could apply sunscreen first and then ordinary makeup over that.
For even better results, your doctor might have you use tretinoin cream (Retin-A), along with the hydroquinone. You may already be familiar with Retin-A as a treatment for acne or sun-induced wrinkles.
Jay Siwek, chairman of the department of family medicine at Georgetown University Medical Center, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.
Consultation is a health education column and is not a substitute for medical advice from your physician. Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, DC 20071. Questions cannot be answered personally.