Out, damned spot! Out, I say! | BareFacedTruth.com

Out, damned spot! Out, I say!

Macbeth, Act 5, Scene 1.  Lentigo monologue.

 In truth, Lady Macbeth had it fairly easy. A little soap and water and her spot would theoretically be gone. The spot on her soul, however, is a more serious problem. Holy water would be just a start.  In today’s post, we’ll address spots of a different color, or rather, multiple colors – lentigos.

What is a lentigo?

A lentigo (plural lentigines) is a small, pigmented flat or slightly raised spot with a clearly defined edge surrounded by normal-appearing skin.  Lentigo or lentigines may appear suddenly or evolve slowly over years.  They may occur anywhere on the body and vary in color from light tan to brown to black. Viewed under the microscope a lentigo shows an increased number of normal melanocytes, the skin cells that produce the pigment melanin that colors skin either genetically or as a result of exposure to UV light.

In a lentigo, melanocytes appear to replace keratinocytes in the basal layer of the epidermis. Lentigines are not the same as common skin moles (nevus, pl. nevi) in which melanocytes are found is “nests” or clusters. Although both nevi and lentigines are benign by nature, they must be carefully examined to differentiate them from early pigmented skin cancers such as melanomas.

What are the features of a lentigo?

Lentigines  have been classified into many different types depending on what they look like, where they appear on the body, causative factors, and whether they are associated with other diseases or conditions.

Lentigo   simplex
Most common form of lentigo that appears at birth or inearly childhood.Not necessarily associated to sun exposure or any medical conditions.Small dark papule, sometimes with dry surface.




Solar Lentigo   

Commonly known as age spots or liver spots.
Benign sun-induced lesion that occurs insun-exposed areas, e.g. face, arms, hands.
Not associated with any medical conditions.

Ink Spot Lentigo   

Usually a single black spot among a number of solar lentigines.

Occur most commonly in patients of Celtic ancestry.’


PUVA Lentigo   

Persistent, pale to dark brown flat spot appearing 6 months or longer after the start of PUVA (psoralen – UVA) therapy.

Similar in appearance to solar lentigines but lesions often have more irregular borders.



Similar to sun-induced lesions but often associated with signs of other long-term skin radiation damage such as epidermal atrophy, SC fibrosis, keratosis and telangiectasias. Does not appear to occur after local radiation therapy but from exposure to a large single dose of ionising radiation (e.g. exposure from the Chernobyl nuclear accident)



Tanning Bed Lentigo   

Usually occurring in women with a history of tanning-bed use. Lesions may appear soon after exposure or they may appear after prolonged regular use of tanning beds.


Oral and labial melanotic macules 

Appear as a single, small (<4mm) lesion on the red part of the lower lip (labial) and inside themouth on the gums,
inside of the cheeks, roof of the mouth and tongue.
Sometimes seen insyndrome-associated lentigines.
Also called labial melanosis.



Lentigines Profusa

Also known as generalized lentigines and is characterized by numerous  lentigines without signs of associaed conditions or triggering factors. The many small lesions may join together to form colored patches. Often involves the extremities, turnk, palms and genitalia.


What treatments are available?

Lentigines require no specific treatment. A broad-spectrum sunscreen may help to prevent further appearance and darkening of solar lentigines. Several creams may lighten lentigines if applied for a number of months. These include hydroquinone or antioxidants such as alpha hydroxyl acids, Vitamin C, and retinoids.

BFT authors, Drjohn and Drgeorge have documented improvements in lentigos (some outright disappear) with topically applied adult mesenchymal stem cell cytokines.  We have some pictures we are gathering, and will append here. Our work in this field is continuing.




  1. rennyjon says:

    I have lentigo spots on my face, and nothing has worked. I read that you guys are going to be releasing a product. May I ask when? Have you seen results with brown age spots? Thanks.

    • drjohn says:

      Hi rennyjon. Yes, in our clinical trial we saw remarkable improvement in lentigo; in fact there seems to be an effect of stem cytokines on all sorts of spots and discolorations. Even vitiligo (white spots, typical on arms/legs from sun damage or immune reations) fade. The product will be released within a week or so.

  2. Susan Dent says:

    Hi, I came here from TIA. I’m not a member there, though I have posted comments there a few times and enjoy reading about the different things that are coming out and the science that might be behind it. I know that TIA is kind of held in some suspicion here.

    I am one of those awful people with a small amount of knowledge, but not enough to really be able to talk about what’s going on inside skin. For instance I hear that younger folk have more collagen type III in their skin than older folk, who have predominantly coll type I (though that too diminshes after age 35) and that this may be a reason we over-35’s have an older face shape even if the skin’s still smooth or just the reason why kids have such smooth skin?… But I certainly don’t know that for sure, or the science behind it, especially the leap between our changing collagen type and looking older.

    (That tangent to illustrate that I have a bit of knowledge, but not enough to ever formulate skin care or pick out what is bogus…)

    To me, your studies and upcoming product based on mesenchymal stem cell cytokines sound very interesting. But I suddenly felt a moment’s suspicion that the stem cell cytokines can also fade spots.
    I’d better go read some more and see if I can educate myself. -Susan

    • drjohn says:

      Hi Susan. Glad you are here, and asking those hard questions. Yes, cytokines are associated with fading of “age spots” which are really concentrations of melanin (skin pigment) IS CLUMPED. It is due to photoaging and intrinsic aging as well. Post-inflammatory hyperpigmentation (PIH) is a more generic term, becuawe these clumps are generally associated with inflammatory events. Acne scars are commonly pigmented, even at younger ages. One of the things we do with cytokines is to change from inflammatory to anti-inflammatory patterns. In doing so, we note the fading of pigmented lesions of all sorts. Not just brown& yellow, but also red (ask Dr George how he cured his rosacea problem). Also we must say that we a lot of other great biochemicals to our final formulation including niacinamide, Vit C, Vit E, catechins, and flavanoids, all of which are tyrosinase inhibitors (impede production of melanin).

  3. Susan Dent says:

    Apologies if the tone of the above comment seemed a little ‘off’ – after reading some more on your work, I am more than impressed, and a little staggered.
    Appreciate the effort you both make to explain very complex mechanisms to the consumer – more than anything I’ve seen yet on the net. If only we were given that sort of science about ingredients like Renovage, which I would have LOVED to be for real.

    • drjohn says:

      Thanks. We all want these things to be real. But the industry has made many of us a bit cynical by creating myths & science impossibilities. But there are some really exciting things on the horizon. Hang in there, but do continue to be discerning.

  4. James says:

    Hi, I made a terrible mistake and rubbed raw lemon into my facial skin, causing severe reaction. Now there is a section-spot of darker, discolouration on the skin.

    • drjohn says:

      Yikes, James. Post-inflammatory hyperpigmentation, pr PIH. Apply anti-inflammatory serums (but not steroids) to begin to reverse. Hyaluronic acid alone may help. Stem cytokines, or course, even better.

Leave a Comment