Endless Australian summers are a treasured part of our lifestyle. However, we pay a price for our sun worship with a high rate of sunspots.
Sunspots are rough, scaly skin lesions, ranging mostly from 2 to 10mm. They usually begin as an area of pink or red skin, which develops a surface scale and can become quite thickened.
Sunspots are found on sun-exposed areas especially the face, ears, bald scalp, neck, backs of hands and forearms.
One in 2 adults over 40 years has at least one sunspot (solar keratosis) with an average of 6-8 lesions. Fair-skinned people and outdoor workers are most at risk.
Why do they matter?
Although sunspots themselves are harmless they are unsightly and can be uncomfortable. More importantly, they can progress to a serious type of skin cancer called squamous cell carcinoma (SCC) which can be fatal if left untreated.
Treating individual spots
Traditional treatment involves destroying individual lesions. Freezing (cryotherapy) with liquid nitrogen spray is the most popular method. It is usually effective but can cause pain, redness and blistering and may leave a pale scar.
Curettage (removal with a sharp instrument) plus cautery (burning) is also used, as well as surgery for thicker lesions. These two methods require a local anaesthetic and cause scarring.
Field therapy is the latest approach for treating a region with many sunspots, e.g. the forehead. A cream or gel (script only) is applied to the whole area (‘the field’) and eliminates visible lesions as well as those that can’t yet be seen. Field treatments give a good cosmetic result but can cause skin redness and irritation.
The latest treatment, a new gel formulation of 3% diclofenac + hyaluronic acid, is applied twice daily for 60-90 days to a field or single lesion. It is well tolerated and causes less inflammation than some other therapies. Other field treatments are 5-fluorouracil and imiquimod creams.
People with sunspots should have regular skin checks and try to minimise future sun exposure. If you have any persistent, scaly spots show your GP.