Field Notes · November 14, 2025 · 6 min · By Marisol Etcheverry
Age spot or melanoma, how to tell the difference
The ABCDE rule, and the single most important habit for anyone with sun-aged skin.
Most brown spots that appear on the face, hands, and shoulders after years of sun are solar lentigines, age spots. They are flat, uniform in color, and harmless. But the same sun exposure that creates them also raises the risk of melanoma, and early melanoma can masquerade as an ordinary spot.
The screening shorthand is ABCDE: Asymmetry, Border irregularity, Color that varies within one lesion, Diameter larger than a pencil eraser, and Evolution, any change in size, shape, or color over weeks to months. An age spot is symmetric, evenly tan-to-brown, and stable for years. A spot that itches, bleeds, or changes is not something to watch and wait on.
The practical rule: any new or changing pigmented lesion in adulthood deserves a look from a board-certified dermatologist, ideally with dermoscopy. A two-minute exam settles the question that no amount of internet searching can.
If a spot is confirmed benign and you simply dislike how it looks, that is a cosmetic decision, and a reasonable one. Treatments from targeted lasers to prescription topicals can fade lentigines reliably. But cosmetic fading should always come after the diagnostic question is answered, never before.
Related reading: Hand rejuvenation: the forgotten age giveaway.