What's the difference between a sun spot and a freckle?

Freckles typically appear in childhood, are small, and fade significantly in winter when sun exposure decreases. Solar lentigines typically appear in adulthood, are larger and more sharply defined, and persist year-round regardless of season. Both are driven by UV exposure and tend to occur in fair skin, but they are biologically different — freckles reflect increased pigment production by normal-numbered melanocytes, while solar lentigines also involve mild architectural changes (elongated rete ridges, slightly increased melanocytes) on histology.

What's the difference between a sun spot and a mole?

A mole (melanocytic naevus) is a benign growth made from clusters ('nests') of melanocytes, typically slightly raised, often appearing in childhood or adolescence. A solar lentigo is a flat pigment-pattern change driven by UV exposure — melanocytes may be slightly increased but they are dispersed rather than nested, and much of the visible pigment is within ordinary epidermal cells. Both can look brown but are biologically different and are assessed differently under dermoscopy and histology. See Harmless moles (naevi) for the mole pathway.

Which treatment is best for my sun spots?

It depends on the number, size and location of the spots and your skin type. Isolated, well-defined spots on face or hands — pigment laser (Q-switched / picosecond) is typically the most precise and cosmetically refined option. Multiple spots with broader background sun damage — IPL allows a whole-area approach. Selected single spots where pigment laser is not optimal — Er:YAG ablative laser, but with more downtime. Widespread mild pigment — topical lightening agents like mequinol + tretinoin. All pathways combine with strict daily SPF to prevent recurrence.

How many treatment sessions will I need?

Pigment laser — often 1–2 sessions per spot for discrete lesions, with the spot darkening immediately, light crusting, and clearance over 7–10 days. IPL — typically a course of 3–5 sessions spaced 3–4 weeks apart for whole-area improvement. Er:YAG — often 1 session per spot but with more downtime and longer healing. Topical agents — gradual improvement over 3–6 months of consistent daily use. Your specific plan is confirmed at consultation.

Will the sun spots come back after treatment?

Treated spots are usually substantially lightened or cleared, but new spots can develop over time with ongoing UV exposure, and treated spots can sometimes darken again without diligent sun protection. Daily broad-spectrum SPF 50+ is the single most important factor in preventing recurrence — randomised-trial evidence supports this. Hats, sunglasses, protective clothing, avoiding solariums and avoiding intense midday UV all contribute.

Are sun-spot treatments safe in darker skin types?

With caution and the right device choice, yes. Darker Fitzpatrick skin (IV–VI) has higher risk of post-inflammatory hyperpigmentation after pigment-targeted treatments and higher risk of hypopigmentation from cryotherapy. Long-pulsed lasers, lower fluences, longer pulse durations, test-spotting and a conservative pathway reduce this risk. Patients in this group are typically reviewed via our Skin of Colour Clinic pathway. Strict sun protection in the post-treatment window is particularly important for darker skin to avoid rebound pigmentation.

When does a "sun spot" warrant biopsy rather than cosmetic treatment?

Any spot that is new and enlarging in adulthood, changing in shape, border or colour, showing multiple colours, symptomatic (itchy, tender, bleeding, crusting), or that looks different from your other spots (ugly duckling) warrants assessment before cosmetic treatment. Particularly on the face in older patients, lentigo maligna can look very similar to a benign solar lentigo, and the safer pathway is biopsy and histology before any cosmetic ablation. If the lesion is benign, cosmetic treatment can proceed afterwards.

Pigmented lesions

Solar Lentigo(Sun Spots)

Name: Solar Lentigo (Sun Spots) Melbourne — Doctor-Led
Published: 2026-06-06

Solar lentigines (singular — solar lentigo) are very common, harmless, flat brown marks that develop on sun-exposed skin over time. People often call them "sun spots" or "age spots". They are benign, but because some early skin cancers can look similar, it is important to have changing or unusual lesions assessed before considering cosmetic treatment.

By Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA

Last reviewed 2026-06-06 · Editorial policy

In brief

Solar lentigines are benign — but lentigo maligna and other early skin cancers can mimic them, so assessment matters before cosmetic treatment.
Pigment lasers (Q-switched or picosecond) are often the best option for isolated, well-defined spots — typically 1–2 sessions per spot.
IPL is a useful whole-area approach when there are multiple spots and background sun damage.
Er:YAG ablative laser is an option for selected single spots but has more downtime than pigment lasers.
Topical lightening agents (e.g. mequinol + tretinoin) have clinical-trial evidence for gradual improvement and are useful as adjunct or maintenance.
Cryotherapy can work for selected lesions but carries higher hypopigmentation risk, especially in darker Fitzpatrick skin types.
Daily broad-spectrum SPF 50+ reduces visible photoageing in randomised-trial data and is the most important factor in preventing recurrence.
Long-pulsed 1064 nm Nd:YAG and conservative IPL settings are safer choices in darker skin types, often via our Skin of Colour Clinic pathway.
Atypical, changing or facially-located pigment lesions in older patients warrant dermoscopy and sometimes biopsy before any cosmetic ablation.
New spots can develop with ongoing UV exposure — treatment + sun protection is a partnership, not a one-off fix.

Quick definition

A solar lentigo (plural: solar lentigines) is a common, benign, flat brown mark that develops on sun-exposed skin — often called a “sun spot” or “age spot”. Driven by cumulative UV exposure, they sit on a spectrum of photoageing alongside other sun-damage changes. Treatment is optional — they are not cancer. However, important lesions can mimic them — particularly lentigo maligna (melanoma in situ) on the face — so doctor-led dermatoscopic assessment is essential before any cosmetic treatment. Cosmetic options include pigment lasers (best for discrete spots), IPL (whole-area approach), Er:YAG ablative laser (selected single spots), topical lightening agents and cryotherapy. Strict daily SPF 50+ is the most important factor in preventing recurrence.

Solar lentigines (the plural of solar lentigo) are very common, harmless, flat brown marks that develop on sun-exposed skin over time. People often call them “sun spots” or “age spots”. They are benign (not cancer), but because some early skin cancers can look similar, it is important to have changing or unusual lesions assessed.

What causes solar lentigines?

A solar lentigo is a flat, well-defined area of increased pigment that persists — unlike freckles, which often fade in winter.

They are most common on:

Face (especially cheeks/temples)
Backs of hands and forearms
Shoulders, chest, upper back

The main cause is cumulative ultraviolet (UV) exposure from sunlight (and solariums). Over years, repeated UV exposure leads to localised pigment changes in the epidermis (top layer of skin), often alongside other sun-damage changes in the surrounding skin.

What is it histologically?

On microscopy, a typical solar lentigo shows:

Increased melanin (pigment) in the basal layer of the epidermis
Often a mild increase in melanocytes, particularly at the tips of elongated rete ridges
“Bulb-like” or elongated rete ridges, with solar elastosis (sun damage) commonly present in the dermis beneath

In plain language: it is mostly a pigment pattern change driven by UV exposure, rather than a “mole growth”.

Histological diagram of solar lentigo showing a cross-section of skin with the epidermis, dermis and subcutis labelled. The diagram highlights four features: elongated rete ridges (the finger-like projections of the epidermis are longer than normal); mildly increased melanocytes at the tips of the elongated rete ridges; increased pigmentation within ordinary epithelial cells (not just melanocytes); and solar elastosis — a band of damaged, clumped collagen visible in the dermis beneath, indicating sun damage. — Figure 1. Histological features of solar lentigo — elongated rete ridges, mildly increased melanocytes, increased pigmentation in epithelial cells, and solar elastosis in the underlying dermis.

How is it different from a mole?

A mole (melanocytic naevus) is a benign growth made from clusters (“nests”) of melanocytes. A solar lentigo is different — melanocytes may be slightly increased, but they are generally dispersed rather than forming nests, and much of the visible pigment relates to pigment within ordinary epidermal cells. Both can look brown, but they are biologically different lesions and are assessed differently under dermoscopy and histology.

When should a “sun spot” be checked?

Most solar lentigines are harmless, but some important lesions can mimic them — especially on the face, including lentigo maligna (melanoma in situ). Dermoscopy helps, but if there is uncertainty, a biopsy may be required for definitive diagnosis.

Seek review if a spot is:

New and enlarging in adulthood
Becoming more irregular in shape or border
Developing multiple colours (brown/black/grey/blue/red/white)
Symptomatic (itchy, tender), crusting, bleeding, or persistently inflamed
Clearly “different” from your other spots (“ugly duckling”)

Treatment options (overview)

Treatment is optional — solar lentigines are benign. The best choice depends on the spot’s size and location, your skin type, and your preference. Recurrence can occur, especially without strong UV protection.

Quick guide (how we choose):

Isolated, well-defined spots (face/hands): often best suited to pigment laser
Selected single spots (when appropriate): Er:YAG (erbium) ablative laser can be considered, but usually has more downtime than pigment lasers
Gradual improvement / maintenance: topical lightening agents can help, especially when treating broader areas
Multiple spots and widespread sun damage: IPL is often a practical whole-area approach

Pigment lasers (Q-switched / picosecond)

Pigment lasers deliver extremely short pulses of energy that are selectively absorbed by melanin. This breaks pigment into tiny fragments that your body clears over days to weeks.

Why pigment lasers are often the “go-to” for discrete sun spots:

High precision for individual lesions
Excellent cosmetic outcomes in appropriate patients
Often 1–2 sessions per spot, depending on depth and darkness

What to expect:

The spot often darkens immediately after treatment
A light crust may form and sheds over approximately 7–10 days
Strict sun avoidance and protection is essential afterwards

Er:YAG (erbium) ablative laser (selected single spots)

Er:YAG ablative laser works by precisely resurfacing very thin layers of the epidermis, removing the superficial pigment as the area heals.

Trade-offs compared with pigment lasers:

Generally more downtime than Q-switched/picosecond pigment lasers
More redness, crusting, and a longer healing phase
Careful aftercare and strict sun protection are essential to reduce pigment rebound

Topical lightening agents (gradual)

Topicals won’t remove a discrete lentigo as quickly as a pigment laser, but they can be useful when there are many areas of pigment, you want gradual improvement, or you are combining with procedural options and maintenance. A fixed combination of mequinol 2% + tretinoin 0.01% has clinical trial evidence for improving solar lentigines.

IPL (intense pulsed light)

IPL can improve solar lentigines and is often useful when there are multiple spots and broader background sun damage, allowing a whole-area approach.

Cryotherapy (freezing)

Liquid nitrogen cryotherapy can be effective for selected lesions. Potential downsides include temporary crusting, blistering and a small risk of lighter marks (hypopigmentation) — risk is higher in darker skin types.

Preventing recurrence (UV protection)

Even if a spot is removed or lightened, ongoing UV exposure can cause new spots and can darken or bring back existing ones. Daily sunscreen use has evidence for reducing progression of visible photoageing in randomised trial data.

Practical habits:

Broad-spectrum SPF daily on exposed areas
Reapply when outdoors (especially prolonged exposure)
Hats, sunglasses, protective clothing, shade
Avoid solariums

References

DermNet NZ. Solar lentigo.
DermNet NZ. Lentigo pathology (histology features).
DermNet NZ. Brown spots, lentigos and freckles (differential diagnosis).
Bohnert K et al. Q-switched Nd:YAG vs dual-pulsed 532/1064-nm Q-switched laser for solar lentigines. 2018.
Noh TK et al. Comparative Q-switched Nd:YAG laser approaches for lentigines.
Hughes MCB et al. Sunscreen and prevention of skin aging: a randomized trial. 2013.
Fleischer AB Jr et al. Mequinol 2% + tretinoin 0.01% improves solar lentigines. 2000.

Symptoms

Flat, well-defined brown patches — distinct from the slightly raised feel of a mole or seborrhoeic keratosis.
Even tan, brown or dark brown colour within a single lesion (multiple colours within one lesion warrant assessment).
Persistent — unlike freckles, they do not fade significantly in winter.
Located on sun-exposed sites — face (especially cheeks and temples), backs of hands and forearms, shoulders, chest and upper back.
Often multiple, clustered or scattered across sun-damaged skin alongside other photoageing changes.
May be a few millimetres to over a centimetre across, with smooth or slightly irregular but well-demarcated borders.

Causes & contributors

Cumulative ultraviolet (UV) exposure from sunlight — the dominant driver, particularly over years of unprotected sun exposure.
Use of solariums and tanning beds.
Fair skin (Fitzpatrick I–III) — higher susceptibility, though solar lentigines can occur in all skin types.
Significant outdoor occupation or recreation history (farming, building, water sports, golf, gardening).
Childhood and adolescent sun exposure — strong cumulative contributor decades later.

Diagnosis

Most solar lentigines can be diagnosed clinically and dermatoscopically based on a flat, well-defined area of increased pigment on sun-exposed skin in a patient with other photoageing features. Assessment matters before any cosmetic treatment because several important lesions can mimic a sun spot — particularly on the face — including lentigo maligna (melanoma in situ on chronically sun-damaged skin), pigmented seborrhoeic keratosis, lichenoid planus-like keratosis, and pigmented actinic keratosis. Dermoscopy improves accuracy substantially, but where features are atypical or evolution is reported, biopsy is the safer pathway before any cosmetic ablation. Lasering a lentigo maligna instead of diagnosing it is a serious diagnostic delay.

Treatment options

Doctor-led assessment with dermoscopy

Every cosmetic treatment begins with a doctor-led dermatoscopic assessment to confirm the lesion is a benign solar lentigo and not a mimic (lentigo maligna, pigmented seborrhoeic keratosis, pigmented actinic keratosis, LPLK). Atypical or evolving lesions go via biopsy, not cosmetic laser.

Pigment lasers (Q-switched / picosecond)

Often the best option for isolated, well-defined spots on face or hands. Extremely short pulses are selectively absorbed by melanin, fragmenting pigment for clearance over days to weeks. Typically 1–2 sessions per spot. The spot darkens immediately, light crust may form, and shedding occurs over ~7–10 days. Excellent cosmetic outcomes in appropriate patients with strict post-treatment sun protection.

IPL (intense pulsed light)

Useful whole-area approach when there are multiple spots and broader background sun damage across face, hands or chest. Treats pigment and vascular components of photoageing simultaneously. Generally requires multiple sessions and is less precise than pigment lasers for discrete spots.

Er:YAG ablative laser (selected single spots)

For selected single lesions where pigment laser is not optimal. Resurfaces very thin layers of the epidermis, removing superficial pigment as the area heals. More downtime than pigment lasers — more redness, crusting and longer healing. Careful aftercare and strict sun protection essential to reduce pigment rebound.

Topical lightening agents

Useful for gradual improvement across broad areas or as maintenance between in-clinic procedures. Mequinol 2% + tretinoin 0.01% has clinical trial evidence for improving solar lentigines. Slower than laser; better suited to widespread mild pigment than discrete dark spots.

Cryotherapy (selected lesions)

Liquid nitrogen can be effective for selected lesions. Potential downsides — temporary crusting, blistering, and a small risk of hypopigmentation (lighter marks), which is higher in darker Fitzpatrick skin types. Less commonly chosen than pigment laser for cosmetic outcomes on the face.

Strict daily UV protection (prevents recurrence) →

The most important long-term treatment. Daily broad-spectrum SPF 50+ has randomised-trial evidence for reducing progression of visible photoageing. Hats, sunglasses, protective clothing and avoidance of solariums round out the protective package. Without sun protection, new lentigines develop and treated lesions may darken again.

When to see a doctor

Seek review before any cosmetic treatment if a "sun spot" is new and enlarging in adulthood, becoming more irregular in shape or border, developing multiple colours (brown / black / grey / blue / red / white within a single lesion), symptomatic (itchy, tender), crusting, bleeding or persistently inflamed, or clearly different from your other spots (the "ugly duckling"). On the face in particular, lentigo maligna (a slow-growing melanoma in situ on chronically sun-damaged skin) can mimic a benign solar lentigo, so changing facial pigment on older patients warrants a low threshold for assessment and sometimes biopsy. Patients with a history of significant sun exposure, fair skin or prior skin cancers benefit from establishing regular full-body skin-check surveillance via our Skin Checks pathway.

Frequently asked questions

Are sun spots dangerous?

No — solar lentigines themselves are benign and not cancerous. However, important lesions can mimic them, especially on the face — including lentigo maligna (a slow-growing melanoma in situ on chronically sun-damaged skin), pigmented seborrhoeic keratosis, pigmented actinic keratosis, and lichenoid planus-like keratosis. This is why doctor-led dermatoscopic assessment before any cosmetic treatment matters. Lasering a lentigo maligna instead of diagnosing it is a serious diagnostic delay.
What's the difference between a sun spot and a freckle?

Freckles typically appear in childhood, are small, and fade significantly in winter when sun exposure decreases. Solar lentigines typically appear in adulthood, are larger and more sharply defined, and persist year-round regardless of season. Both are driven by UV exposure and tend to occur in fair skin, but they are biologically different — freckles reflect increased pigment production by normal-numbered melanocytes, while solar lentigines also involve mild architectural changes (elongated rete ridges, slightly increased melanocytes) on histology.
What's the difference between a sun spot and a mole?

A mole (melanocytic naevus) is a benign growth made from clusters ('nests') of melanocytes, typically slightly raised, often appearing in childhood or adolescence. A solar lentigo is a flat pigment-pattern change driven by UV exposure — melanocytes may be slightly increased but they are dispersed rather than nested, and much of the visible pigment is within ordinary epidermal cells. Both can look brown but are biologically different and are assessed differently under dermoscopy and histology. See Harmless moles (naevi) for the mole pathway.
Which treatment is best for my sun spots?

It depends on the number, size and location of the spots and your skin type. Isolated, well-defined spots on face or hands — pigment laser (Q-switched / picosecond) is typically the most precise and cosmetically refined option. Multiple spots with broader background sun damage — IPL allows a whole-area approach. Selected single spots where pigment laser is not optimal — Er:YAG ablative laser, but with more downtime. Widespread mild pigment — topical lightening agents like mequinol + tretinoin. All pathways combine with strict daily SPF to prevent recurrence.
How many treatment sessions will I need?

Pigment laser — often 1–2 sessions per spot for discrete lesions, with the spot darkening immediately, light crusting, and clearance over 7–10 days. IPL — typically a course of 3–5 sessions spaced 3–4 weeks apart for whole-area improvement. Er:YAG — often 1 session per spot but with more downtime and longer healing. Topical agents — gradual improvement over 3–6 months of consistent daily use. Your specific plan is confirmed at consultation.
Will the sun spots come back after treatment?

Treated spots are usually substantially lightened or cleared, but new spots can develop over time with ongoing UV exposure, and treated spots can sometimes darken again without diligent sun protection. Daily broad-spectrum SPF 50+ is the single most important factor in preventing recurrence — randomised-trial evidence supports this. Hats, sunglasses, protective clothing, avoiding solariums and avoiding intense midday UV all contribute.
Are sun-spot treatments safe in darker skin types?

With caution and the right device choice, yes. Darker Fitzpatrick skin (IV–VI) has higher risk of post-inflammatory hyperpigmentation after pigment-targeted treatments and higher risk of hypopigmentation from cryotherapy. Long-pulsed lasers, lower fluences, longer pulse durations, test-spotting and a conservative pathway reduce this risk. Patients in this group are typically reviewed via our Skin of Colour Clinic pathway. Strict sun protection in the post-treatment window is particularly important for darker skin to avoid rebound pigmentation.
When does a "sun spot" warrant biopsy rather than cosmetic treatment?

Any spot that is new and enlarging in adulthood, changing in shape, border or colour, showing multiple colours, symptomatic (itchy, tender, bleeding, crusting), or that looks different from your other spots (ugly duckling) warrants assessment before cosmetic treatment. Particularly on the face in older patients, lentigo maligna can look very similar to a benign solar lentigo, and the safer pathway is biopsy and histology before any cosmetic ablation. If the lesion is benign, cosmetic treatment can proceed afterwards.

References

Related conditions

Related treatments

Pigmentation Consultation

Medically reviewed by Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA · Last reviewed 2026-06-06 · Editorial policy