Freckles

What Are Freckles?

Freckles are extra patches of coloring (or pigment) under your skin. Doctors call them 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.

Types of freckles

There are two types of freckles: ephelides and solar lentigines. Although both are flat spots, they’re different in a few ways.

Ephelides (freckles):

  • Are genetic
  • First show up when you’re around 2-3 years old, often after you’ve been in the sun
  • Are usually on your arms, chest, face, and neck
  • Can be red, dark brown, or light brown
  • Can go away as you age
  • May fade during the winter
  • Are usually about 1-2 millimeters or bigger
  • Have irregular borders that aren’t very defined

Solar lentigines:

  • Are sometimes called age spots, sunspots, or liver spots
  • Show up as you get older and are common if you’re 50 or older
  • Can be anywhere on your body that gets sun, including areas like your back, chest, face, forearms, hands, and shins
  • Don’t fade or disappear
  • Can range from light yellow to dark brown in color
  • Show up because of sun exposure and aging
  • Have clear borders

Freckles Causes and Risk Factors

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

Too much sun may also cause your skin to become:

  • Tanned
  • Sunburned
  • Blotchy

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Freckle Treatment

Natural freckles don't need treatment. They aren’t a sign of a skin problem. As you get older, they may get lighter on their own or go away entirely, depending on what type of freckle they are.

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)
  • Laser treatments
  • Cryotherapy (skin freezing)
  • Chemical peels
  • Creams like retinol, a form of vitamin A

A dermatologist will need to decide which treatment is best for you.

You should see a doctor if your freckles:

  • Have jagged borders
  • Aren’t symmetrical
  • Are sore
  • Have a diameter of more than 6 millimeters (about the size of a pencil eraser)
  • Become raised off of your skin
  • Have dark patches or multiple colors
  • Start to grow or change size or colors

Freckle Prevention

You can avoid getting more freckles by protecting yourself from the sun. Some of the best ways are:

  • Always wear a water-resistant sunscreen with broad-spectrum protection and an SPF of 30 or higher (even when it’s not sunny).
  • Never use tanning beds.
  • Don’t get sunburned.
  • Stay in the shade, especially from 10 a.m. to 4 p.m.

Freckles vs. Sunspots

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

Sunspots 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 sunspots, too.

If you have sunspots, 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

Sunspots 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.

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Freckles vs. 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, your doctor should be able to remove it with a short in-office procedure. Never try to remove a mole yourself. It can cause a scar or infection.

If you notice any changes to a mole, or if it gets itchy or starts 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, they'll remove the entire mole. Skin cancer is easiest to treat when you find it early.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on September 16, 2020

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," “Sunscreen FAQs.”

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."

Pigment Cell & Melanoma Research: “Sun‐induced freckling: ephelides and solar lentigines.”

Harvard Health Publishing: “Age Spots (Solar Lentigo, Liver Spots).”

Mayo Clinic: “Age spots (liver spots).”

Prevent Cancer Foundation: “Save Your Skin.”

Cleveland Clinic: “Q & A: Freckles and Your Skin.”

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