What to know about freckles – Medical News
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What to know about freckles

Freckles are small, harmless marks that appear on the skin. Genetics and sun exposure are the primary causes of freckles.

Some people are more likely to get freckles than others, depending on their genes and skin type. If a person is genetically more likely to develop freckles, exposure to sunlight can make them appear.

Freckles are common in children and may disappear or become less noticeable as they grow up.

In this article, we look at what causes freckles, how to distinguish them from other similar marks, ways to remove or lighten them, and when to see a doctor or a skin doctor called a dermatologist.

What causes freckles?

Freckles appear when melanin, the pigment that gives skin its color, builds up under the skin. Freckles may look brown, red, or tan.

Sun exposure and genetic factors make some people more likely to develop freckles:

Sun exposure

What To Know About Freckles's face
Sun exposure and genetics can cause freckles.

A person’s skin cells produce extra melanin to protect the skin from sun damage. This is why freckles tend to appear after sun exposure.

Freckles can appear over a large area of skin and can reappear or become darker in the summer months. Freckles often fade or disappear in the winter months, when new skin cells replace old cells.

Freckles develop on areas often exposed to sunlight, such as the:

  • face
  • arms
  • neck
  • back
  • chest

Genetics

Genetics also play a leading role in who is more likely to develop freckles based on which type of melanin their body produces.

The body can produce two types of melanin called pheomelanin and eumelanin. Eumelanin protects the skin from UV rays, but pheomelanin does not.

The type of melanin the body produces depends on a gene called MC1R.

  • People with dark hair, eyes, and skin usually produce mostly eumelanin and are less likely to develop freckles.
  • People with red, blonde, or light brown hair and who have light-colored skin and eyes usually produce mainly pheomelanin and are more likely to develop freckles.


Are freckles dangerous?

Freckles are not dangerous. However, as people with freckles have skin that is more sensitive to sunlight, they should take extra care to protect their skin from the sun.


How to identify freckles, sun spots, and moles

Sun spot on the hand <em>Image credit: DermNet New Zealand</em> - What To Know About Freckles
Sun spots can resemble freckles.
Image credit: DermNet New Zealand

Freckles can look very similar to other marks that develop on the skin. For example, they can look like sun spots, also known as age spots, or liver spots.

Sun exposure is a primary cause of both freckles and age spots. Age spots are typically larger than freckles, are more clearly defined, and tend to appear in older adults.

While freckles are more widespread on people with light-colored hair and skin, age spots develop on people with a wider range of complexions.

Moles are usually present from birth, but people can develop them throughout childhood and teenage years. Moles are generally darker than freckles and can be flat or raised off the skin.

This table shows the differences between common marks on the skin:

Freckles Sun spots Mole
Appearance Flat, can appear in clusters over a large area Flat, can appear in clusters Flat or raised, can appear on their own or in groups
Cause Genes and exposure to sun Exposure to sun When skin cells grow in clusters
At which ages do they appear? Can first appear at 2–3 years old More common in people aged 40 or older From birth, or during childhood and adolescence
Where can they appear on the body? Areas of sun-exposed skin, commonly the face, neck, chest, arms, back Areas of sun-exposed skin, typically the face, hands, arms, shoulders, back Anywhere on the body
Shape Irregular shape with well-defined edges Well-defined edges Round or oval, well-defined edges
Color Tan, brown, or red Tan, brown, or black Light to dark brown, or black
Size (diameter) 1–2 mm or larger 2 mm or larger Usually less than 6 mm
Changes to expect Can fade in winter and become darker in summer Will stay the same; may get darker if left unprotected in sunlight Will stay the same; can sometimes disappear over time


Preventing freckles

People can prevent or reduce the appearance of freckles by protecting their skin from the sun.

Protecting the skin from sunlight will not reduce the appearance of existing freckles, but it can prevent new freckles from forming.

The American Academy of Dermatology (AAD) recommend the following tips to protect the skin in sunlight:

  • wearing a water-resistant sunscreen with UVA and UVB protection, and an SPF of 30 or higher
  • covering up with long sleeves, a hat, and sunglasses
  • staying in the shade when the sun is strongest, between 10 a.m. and 2 p.m.
  • reapplying sunscreen every 2 hours when outside or after swimming or sweating
  • avoiding tanning beds

Home remedies and treatments

Freckles are harmless and do not need treatment.

However, if people want to remove or lighten freckles for cosmetic reasons, some treatments can reduce their appearance.

Over-the-counter treatments

A 2012 study showed that products containing trichloroacetic acid (TCA) and phenol are effective in lightening freckles. A variety of topical creams and spot peels contain these compounds.

Other compounds that may help to fade freckles include:

  • alpha hydroxy acids
  • azelaic acid
  • cysteamine
  • vitamin C
  • retinoids

People can also opt for medical procedures to remove dark spots for cosmetic reasons. These include laser therapy and chemical peels.

All of these treatments can cause side effects, such as scarring. Anyone considering treatments for freckles should discuss all their options with a doctor.

Home remedies

Lemons cut open on a wooden table - What To Know About Freckles
Lemon juice may help to lighten dark spots.

Some people find that certain natural products can lighten their freckles, although these methods are not scientifically proven.

  • Lemons: Apply a small amount of lemon juice to cotton wool and wipe over the skin. The Vitamin C in the lemon juice may help to lighten dark spots, although it is unlikely to be a high enough concentration to make a dramatic difference.
  • Honey: Spread a thin layer of honey on to the skin. Leave it for 5 to 10 minutes, then wash off with warm water. Honey has antioxidant properties, which may help to lighten freckles over time.
  • Aloe vera: Aloe vera contains salicylic acid and aloin. This may help to fade freckles. Use aloe vera from the leaf and apply to the skin.

Using these natural products on your skin is unlikely to cause any side effects, but it is best to do a patch test on a small area of skin first. If it causes any skin irritation, stop using the product.


When to see a doctor

Freckles are harmless, but they can sometimes look similar to some types of skin cancer. If people notice any changes in their skin, they should see a doctor, who will be able to check the skin for anything unusual.

People who have fair skin that freckles or burns easily may be at a higher risk of developing skin cancer. They should, therefore, take extra care when going out in the sun.

People should see a doctor if a mole, freckle, or sun spot:

  • itches
  • bleeds
  • grows
  • changes shape
  • looks different to those around it

People can also use the ABCDE guide to check spots on their skin. Look for:

Asymmetry — does one half looks different to the other half?

Border — does it have poorly defined or scalloped edges?

Color — is it a variety of shades of brown, black, or tan?

Diameter — is it bigger than the size of an eraser on the end of a pencil?

Evolves — has it changed shape, size, or color?

If people have a spot on the skin that matches one or more of the above signs, they should see a dermatologist as soon as possible.

Summary

Freckles are harmless marks on the skin caused by genetics and exposure to sunlight. If people have freckles, they will need to take extra care of their skin in the sun.

If people have any concerns about any new marks or changes to their skin, they should see a doctor or dermatologist who can check the skin for anything unusual.

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