Freckles and How They Differ From Other Skin Spots

Like a lot of people, you may call any dark spot that shows up on your body a "freckle." Whether you think they're cute or wish they'd fade away, not all flecks of color on your skin are the same -- or are safe to ignore.

Learn how to tell what's really a freckle and how to recognize some spots that may need medical attention.

What Are Freckles?

Some people have extra patches of coloring (or "pigment") under their skin. They're commonly called freckles, but doctors know them as "ephelides." You have them because of the genes you were born with.

Freckles often show up during childhood, and you may continue to get more until you're in your 20s. People with fair skin or red hair are most likely to have them.

If your freckles are because of your genes, they will be:

  • Flat, not raised
  • Tan, brown, or red
  • Darker in the summer and lighter in the winter

Natural freckles don't need treatment. They're not a sign of a skin problem. As you get older, they may get lighter on their own or go away entirely.

If you don't like how your freckles look, treatments can help fade them. These include chemicals like alpha hydroxy acid (AHA) and trichloroacetic acid (TCA), as well as lasers and cryotherapy (skin freezing.) A dermatologist will need to decide which treatment is best for you.

You should see a doctor if your freckles:

  • Have jagged borders
  • Are sore
  • Become raised off of your skin
  • Have dark patches or start to grow

The Effects of the Sun

The harmful rays of the sun can make your freckles darker and more noticeable. This is more likely if you have light skin.

Too much sun may also cause your skin to become:

  • Tanned
  • Sunburned
  • Blotchy

A broad-spectrum sunscreen with 30 SPF or higher can protect your skin in the sun.

To try to smooth and clear your sun-damaged skin, a dermatologist can prescribe a special cream like retinol, a form of vitamin A. Chemical peels or laser treatments are also options to clear skin damage that you get from the sun.

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Age Spots

You may confuse freckles for age spots, which are also called "liver spots" or "lentigines." They can appear tan, brown, or black and are common in people who are 50 or older. You can get them if you're younger, though.

Age spots are caused by too much pigment stuck together in one area of your skin. This can happen after many years of spending a lot of time in the sun. Tanning beds can cause age spots, too.

If you have age spots, you could also see:

  • More spots on parts of your body that get sunlight (like your hands, feet, face, and shoulders)
  • Spots as large as a half-inch across

Age spots are harmless, but if you don't like how they look, prescription creams can lighten them. Sometimes you can have them removed.

Have a doctor check out any dark spots on your skin.

Moles

You might mistake moles for freckles, but they're something different. Also called "nevi," moles form when a bunch of your skin cells clump together.

You can find moles anywhere on your body. For instance, you can have them on your scalp, between your toes, and under your nails.

Almost everyone has at least a few moles. Even having dozens is normal.

You're more likely to have moles if you have light skin. They often appear when you're a child.

Moles may look:

  • Round
  • Flat or slightly raised
  • Tan, black, red, pink, blue, skin-toned, or colorless

Most moles don't need treatment. If you don't like how one looks, a doctor can typically remove it ­­with a short in-office procedure. Never try to remove a mole yourself since you can cause a scar or infection.

If you notice any changes to a mole, or if they get itchy or start to bleed, get it checked by a dermatologist. These can be early signs of skin cancer.

The doctor might send a small tissue sample of the mole to a lab for testing. If the test finds cancer cells, she'll remove the entire mole. Skin cancer is easiest to treat when you find it early.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on June 11, 2019

Sources

SOURCES:

KidsHealth: "What Are Freckles?"

American Academy of Dermatology Association: "Freckles and sunburn (ages 11-13)," "Variety of options available to treat pigmentation problems," "Moles."

Mayo Clinic: "Age Spots (Liver Spots.)," "Mayo Clinic Q and A: All About Freckles."

Journal of Cutaneous and Aesthetic Surgery: "A Split-face Comparative Study of 70% Trichloroacetic Acid and 80% Phenol Spot Peel in the Treatment of Freckles."

Skin Cancer Foundation: "Melanoma at Its Most Curable."

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