Why do spots appear on the hands, neck and décolletage?
The most common cause is accumulated sun damage. These areas are exposed for years and often unprotected, so spots and signs of ageing can show here before the face.
The back of the hand, neck and chest have thin skin and relatively little fat. Repeated sun exposure can make pigment-producing cells work unevenly, leading to brown spots known as solar lentigines. Thinning, crinkling and more visible veins often appear in the same areas.
Hormonal changes, some medicines, photosensitising products such as certain perfumes, and a genetic tendency can also increase spotting. The cause is therefore not the same for everyone, and treatment is chosen according to the cause.
Is every brown spot harmless?
No. A spot that changes in colour, border or size, bleeds, crusts or grows quickly should always be examined by a dermatologist.
Sun spots are usually harmless, but actinic keratoses and some skin cancers can look like spots at first glance. For this reason the type of spot must be assessed clinically before any light, laser or peel treatment. Trying to remove a suspicious lesion with cosmetic methods can delay diagnosis.
At the examination, Dr. Berktaş looks at the spot with the eye and, where needed, with a dermatoscope, and refers to dermatology or another specialty if there is doubt. This page gives general information and is not meant to diagnose.
Which methods may be considered?
Depending on the type of spot and the skin, daily skincare, superficial peels, light or laser-based devices and injections that support skin quality may be considered.
Brightening skincare, vitamin C and retinoid routines can be a first step for mild spots. For more marked spots, chemical peels, pigment-targeted lasers or intense light devices may be used, and each carries different risks in different skin types. In darker skin, wrong settings can make a spot darker.
If the skin is also thin and dry, mesotherapy or skin boosters, collagen stimulators, or filler for volume loss on the back of the hand may be discussed separately. Which method is suitable, or whether none is needed, is decided at the consultation.
Do spots come back after treatment?
If the skin is not protected, new spots are expected. Results are not fixed; they change over the years with how the skin responds to sun and age.
How much a spot lightens and how long the improvement lasts varies between people and cannot be stated with certainty in advance. In general, broad-spectrum sunscreen should be used regularly on the hands and neck too; because hands are washed many times a day, reapplying is easy to forget.
Temporary redness, crusting or darkening can occur after treatment. If you notice a burn, blistering or signs of infection, contact the clinic or a dermatologist straight away rather than treating it yourself.
Who should not have these treatments?
Pregnancy, breastfeeding, active infection, recent tanning and the use of photosensitising medicines are examples of situations in which light, laser or peel treatments may be postponed.
Isotretinoin use, an open wound, herpes or an active skin disease in the treatment area can also mean postponing. Suspicious spots without a diagnosis must be assessed before any procedure.
Tell the physician about your medicines, past skin conditions and any tendency to scar. You can also read our safety guides for more detail.
Frequently asked questions
Can hand spots be treated at home?
For mild spots a routine with sunscreen, vitamin C and a retinoid may help some people, but do not try to treat a changing or suspicious spot at home; have it examined first.
Are age spots and sun spots the same?
In everyday speech the two terms are used for the same thing; sun exposure matters more than age. The medical name is usually solar lentigo.
Are neck and décolletage treatments the same as for the face?
No. The skin here is thinner and may heal more slowly, so settings and methods are usually chosen more cautiously.
How many sessions are needed?
It depends on the method and how dense the spots are; several sessions are often discussed. The physician decides the number after the examination.
Can I go out in the sun after treatment?
Avoiding direct sun for a while and using sunscreen regularly is usually advised. The period depends on the method and is given by the physician.
Sources (5)
- American Academy of Dermatology: What can get rid of age spots?
- American Academy of Dermatology: How dermatologists treat sun-damaged skin
- Journal of Cosmetic Dermatology: Treatment of Solar Lentigines: A Systematic Review of Clinical Trials (2025)
- Rivkin AZ (Clin Cosmet Investig Dermatol): Volume correction in the aging hand: role of dermal fillers (2016)
- U.S. FDA: RADIESSE Injectable Implant, P050052/S049 (hand augmentation, Premarket Approval record) (2015)
This content is for general information and does not replace a personal medical assessment.