About freckles

What are freckles?

Freckles facts

  • Freckles are usually are flat small tan or light-brown spots on sun-exposed skin.
  • Freckles themselves are quite harmless and rarely develop into skin cancer.
  • Most freckles are produced by exposure to ultraviolet light.
  • Unusual freckles may become malignant skin cancer.
  • Uncertain colored or pigmented spots should be examined by your physician or dermatologist.
  • Effective treatments are available to help lighten or eliminate bothersome freckles.

What are freckles?

Freckles are flat, tanned circular spots that typically are the size of the head of a common nail. The spots are multiple and may develop on sun-exposed skin after repeated exposure to sunlight. These are particularly common in people of fair complexion on upper-body skin areas like the cheeks, nose, arms, and upper shoulders. They may appear on people as young as 1 or 2 years of age.

Most freckles on a person's skin are usually uniform in color. On different people, freckles may vary somewhat in color -- they may be reddish, yellow, tan, light brown, brown, or -- but they are basically slightly darker than the surrounding skin. They tend to become darker and more apparent after sun exposure and lighten in the winter months. Freckles are due to an increase in the amount of dark pigment called melanin and are not due to an increase in the total number of pigment-producing cells called melanocytes. The word freckle comes from the Middle English freken, which, in turn, came from the Old Norse freknur, meaning "freckled." (Some speakers of Old English and Old Norse must have had a tendency to developing freckles.)

What types of freckles are there?

There are two basic types of freckles: simple freckles and sunburn freckles. Simple freckles are usually tan, round, and small -- about the size of a common construction nail head. Sunburn freckles are often darker, have irregular jagged borders, and may be larger than a pencil eraser. Sunburn freckles are more common on the upper back and shoulders where people frequently get their most severe sunburns.

Ephelides (singular: ephelis) is the Greek word and medical term for freckle. This term refers to flat spots that are tan, slightly reddish, or light brown and typically appear during the sunny months. They are most often found on people with light complexions, and in some families, they are a hereditary (genetic) trait. People with reddish hair and green eyes are more prone to these types of freckles. Sun avoidance and sun protection, including the regular use of sunscreen, help to suppress the appearance of the some types of freckles.

Lentigines (singular: lentigo) comes from the Latin word for lentil and is the medical term for certain types of darker freckles and sunburn freckles. Lentigines tend to be darker than the common freckle and do not usually fade in the winter. This kind of spot is referred to as lentigo simplex. Although occasionally lentigines are part of a certain rare genetic syndrome, for the most part they are just isolated and unimportant spots.

What are "liver spots" or "age spots"?

"Liver spots" or "age spots" are the common names of the darker spots seen in adults, frequently on the back of the hands. The term "liver spot" is actually a misnomer since these spots are not caused by liver problems or liver disease. While lentigines do tend to appear over time, they are not in themselves a sign of old age but a sign of sun exposure.

Sometimes, older people who have these lentigo-type freckles also have raised, brown, crusty lesions called seborrheic keratoses in or around the same areas. Seborrheic keratoses are also benign (not malignant) growths of the skin. Some patients call these growths "barnacles" or "Rice Krispies." Although they are most often medium brown, they can differ in color ranging anywhere from light tan to . They occur in different sizes, too, ranging anywhere from a fraction of an inch (or centimeter) to an inch (2.5 cm) in diameter. Typically, these growths are around the size of a pencil eraser or slightly larger. Some keratoses begin as a flat lentigo and gradually raise and thicken to form a seborrheic keratosis.

The telltale feature of seborrheic keratoses is their waxy, stuck-on, greasy look. They look like they have either been pasted on the skin or may look like a dab of melted brown candle wax that dropped on the skin. Seborrheic keratoses may occur in the same areas as freckles. Seborrheic keratoses are also more common in areas of sun exposure, but they may also occur in sun-protected areas. When they first appear, the growths usually begin one at a time as small rough bumps. Eventually, they may thicken and develop a rough, warty surface.

Seborrheic keratoses are quite common especially after age 40. Almost everybody may eventually develop at least a few seborrheic keratoses during their lifetime. They are sometimes referred to as the "barnacles of old age."

What are the causes for freckles?

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

What are the treatments for freckles?

Since we cannot change our own genetic component of freckling, our main prevention measures are aimed at sun avoidance and sun-protection, including

  1. use of sunscreens with SPF (sun protection factor) 50,
  2. use of wide-brimmed hats (6 inches),
  3. use of sun-protective clothing (shirts, long sleeves, long pants),
  4. avoidance of the peak sun hours of 10 a.m. to 4 p.m.,
  5. seeking shade and staying indoors.

Freckle prevention is more effective than freckle removal. Freckle-reduction treatments are more difficult and not always satisfactory. People with known hereditary tendencies of freckling should start sun protection early in childhood. Much of the sun and UV skin damage occurs often while children are under age 18.

Fair-skinned people who are more prone to freckling and sunburns are also generally more at risk for developing skin cancers. Freckles may be a warning sign of sensitive skin that is highly vulnerable to sunburn and to potential skin cancer.

What are the risk factors for freckles?

Too much sun may also cause your skin to become:

  • Tanned
  • Sunburned
  • Blotchy

Is there a cure/medications for freckles?

Freckles, commonly known as Ephelides are seen as diffused discolouration or tanning in some parts of the face and the body. However, there are some genetic predispositions to this condition. It cannot be caused by genetic factors alone. Sun exposure is one of the important factors in acquiring this condition.

Over-the-counter treatment

  • People with freckles can go for over-the-counter products like AHA toners, trichloroacetic acid, phenol, and acid peels. Toners and creams are topical ointments placed directly on the freckles you want to lighten.
  • Freckles that have appeared because of the sun can be treated with a retinoid cream. Retinoid cream helps to absorb the UV radiation damage.


Treatments at dermatologist's office-

  • To minimize the appearance of freckles, getting a chemical peel can remove the top layer of skin exposing newer undamaged skin. Therefore, freckles will be less noticeable due to this skin layer’s lack of sun damage.
  • Chemical peels can even be used to treat precancerous areas, reduce the appearance of wrinkles, and give you a healthy overall glow.
  • Laser therapy can help lighten or remove freckles. This resurfacing laser targets the water inside the skin’s layers. Once it reaches the middle layer of skin, the old pigmented cells are removed and new collagen is formed. This new collagen can mean the complete removal of freckles.
  • Cryosurgery can also be used to remove freckles. The liquid nitrogen used freezes and destroys unwanted skin cells. Different treatments may need to be used to achieve different results.


Symptoms
Brown or tannish discoloration on the cheek and back
Conditions
Tan and browinish discolouration on skin
Drugs
Over the counter AHA, BHA or retinoid cream,Laser therapy

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