Lentigines are brown, faint and very well defined spots that are usually located on the face, upper back and back of the hands. They are formed by an excess of pigmentation in the deep part of the epidermis and are a consequence of chronic sun exposure, very common in subjects living in the Mediterranean.
Lentigines do not have malignant potential in isolation, although their presence indicates that the skin has accumulated a high solar charge throughout life and for this reason it is known that the incidence of skin cancer in patients with lentigines is higher. In any case, lentigines themselves only represent an aesthetic alteration that can be uncomfortable, since their presence is usually related to old age (‘age spots’).
Single lentigines, which are more common on the face, can be removed or blurred by applying liquid nitrogen at -196ºC, although this procedure must be carried out with exquisite care to avoid irritation, crusting or scarring. It is common for three or four very gentle sessions of cryotherapy to disappear. In multiple lesions, cryotherapy is usually annoying and produces noticeable inflammation, so it is not recommended. Another option is the use of a trichloroacetic acid peel. This procedure is very comfortable, although it is not uncommon for the removal of the lesions to be incomplete when they have some volume (hyperkeratosis) and cause a whitish halo around the spots (hypopigmentation). Both of these facts mean that other therapeutic alternatives are very often chosen.
Whether in single or multiple lesions, the use of a laser device for complete removal is much more effective, comfortable and less annoying. It is the treatment of choice when you want to eliminate solar lentigines. The laser light beam selectively impacts the excess pigment in the lentigines and causes it to disappear, with the advantage of not causing inflammation and being able to treat as many lesions as there are in a single session. The most effective laser devices for the treatment of lentigines are Q switched Nd:YAG and intense pulsed light.
A maximum of three sessions are usually required to completely remove lentigines comfortably.
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Bibliographic references
Polder KD, Landau JM, Vergilis-Kalner IJ, Goldberg LH, Friedman PM, Bruce S.
Laser eradication of pigmented lesions: a review. Dermatol Surg. 2011 May; 37(5):572-95.