Field Notes · December 12, 2025 · 5 min · By Marisol Etcheverry
Why your age spots keep coming back
Clearing a spot and keeping it gone are two different projects.
Patients are often frustrated that spots they paid to remove reappear within a year. The lesion was treated; the biology was not.
Solar lentigines are the visible record of cumulative ultraviolet exposure. The melanocytes that produced them are still present and still primed. Remove the pigment and the cells remain, ready to respond to the next sunny weekend. This is why every credible treatment plan has two halves: clearance and maintenance.
Clearance is the dramatic part, a laser, a peel, a topical course. Maintenance is daily, broad-spectrum SPF 30 or higher, reapplied; a hat on bright days; and frequently a low-strength evening topical such as a retinoid or azelaic acid to keep pigment cells calm.
The people who stay clear are not the ones who found a better laser. They are the ones who treated maintenance as the actual treatment.
Related reading: Melasma vs. age spots: similar look, different fix and Hydroquinone vs. Kojic Acid for Age Spots: Which Brightening Agent Actually Works?.