Pigmentation spots can have various origins (hormonal fluctuations, pregnancy, sun, genetics). Sun spots, also known as lentigos or age spots are due to repeated exposure to the sun's UV rays. Etymologically, lentigo refers to lentils. Sun spots take the form of small flat spots of light brown to black colour. They usually appear around the age of 50, or sometimes even earlier at 40 years old. They are much more prevalent in people with light phototypes.
Sun spots are caused and/or exacerbated by a phenomenon known as oxidative stress.As a reminder, this phenomenon results from the overproduction of pro-oxidant species in cells, and/or the reduction of cellular antioxidant capacity, and can damage DNA, cellular membrane lipids and proteins, leading to mutagenesis or cell death. Reactive oxygen species (ROS) are produced by mitochondria and peroxisomes during normal cellular metabolic processes. However, ROS production can be heightened under pathological conditions, such as inflammation and cancer, as well as when exposed to exogenous factors, like ultraviolet (UV) rays.
The skin is the largest organ interfacing with the environment, and a significant source of Reactive Oxygen Species (ROS) which are induced by sun exposure. Epidermal melanocytes are particularly vulnerable to excessive ROS production due to their specialised function: the synthesis of melanin, which is stimulated by sun exposure during the tanning process. When melanocytes are disrupted, they produce excess and disorganised melanin, leading to brown spots known as solar lentigines.
Lentigos are associated with skin ageing. As we age, the skin fails to fully protect itself from external aggressions and deteriorates. A dysfunction of melanocytes is observed, associated with the exhaustion of their pigmentary potential at the level of hair follicles. This phenomenon is also correlated with the consequences of repeated attacks of reactive oxygen species (or free radicals) on the nuclei of melanocytes and mitochondria. When this happens, the skin becomes vulnerable to UV rays, which are responsible for sun spots also referred to as "age spots".
Note:Solar lentigines are by definition benign lesions, but some can progress to precancerous lesions. This is then referred to as Dubreuilh's melanosis, sometimes also called "malignant lentigo". Even though the mutation from a benign lentigo to a malignant one is slow, it is essential to regularly visit your dermatologist to monitor the possible evolution of these age spots.