Random brown blotches

Hi. I'm a 25 year old female. About a year or two ago I started noticing random dark brown patches appearing on the back of my hands/fingers. They are very small, and look like light brown birthmarks or old scars. They're flat, not itchy, but they are not regular circles. I originally had a few that appeared on my hands in the summer (random "paint splash" shapes) and then later disappeared. This year I have it again. On my hand is a pattern of about four circlish blotches in a zigzag row about a centimetre long. I also have a few on my ankles, one looks like a dark scar (less than 1cm) and one is a lopsided V shape over 1cm.  The one on my hand has started flaking a little bit and is reddish underneath.

Any topical recommendations are appreciated, as I will undoubtedly contact a doctor if it gets worse.

[Bhupinder Kaur, MD]

Hello,
They sound like sun spots. Sun spots or lentigines, are harmless, flat, brown discolorations of the skin which usually occur on the back of the hands, neck and face of people older than 40 years of age. They are caused by the skin being exposed to the sun over many years and are a sigh of sun damage. The on ly way to prevent age spots is to use liberal amounts of sunscreen before the age of forty, avoid the sun, and wear protective clothing. The newest treatment for age spots is an alpha hydroxy acid gel or beta hydroxy acid gel.  Retin-A cream, alpha hydroxyacid peels, and liquid nitrogen therapy are other options.
Hope it helps. Take care and please do keep me posted on how you are doing or if you have any additional queries. Kind regards.