Liver Spots

Q:  I did not think I would be writing to you, but to me this is a serious problem.

All my life I have had numerous brown spots on my abdomen, shoulders and back that I have called "liver spots." I have had quite a few removed during the years by a dermatologist. I also loved the sun and 50 to 60 years ago, we never were told anything like this might happen.

Six months ago, I noticed a lot of new ones on my neck. In this short time it is just unbelievable how many I have on my face. I went to my dermatologist and was told because I was very blonde and fair-skinned, she would not be able to help me -- something about pigment in my body.

Is there anything you could suggest I do to prevent anymore from developing on my face? Could it be my diet? I have eaten a tremendous amount of chocolate candy all my life. Or could it be medication? I have been taking Prednisone for many years because of severe asthma.

A:  Solar lentigo is the medical term for "liver spots." These brownish, flat, round or oval spots are a result of sun exposure over many years and usually start showing up when people hit their 40s. The good news is that they are not cancerous, but they can be treated for cosmetic reasons.

Janet Fairley, MD, Professor of Dermatology at the Medical College of Wisconsin, told me she was puzzled by your dermatologist's comments, because usually fair-skinned people respond the best to treatment. Liquid nitrogen, laser therapy and topical creams containing alpha hydroxy acids or retinoids all have been used to lessen these spots.

Using sunscreen is the most important thing you can do to prevent new lesions. Some of the spots you have now may even fade with good protection. Diet has no effect, so it is highly unlikely that your chocolate or Prednisone is responsible.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.