Laguna Hills, CA 92653
Fellow, American Society of Mohs Surgery
•What are freckles?
• What types of freckles are there?
• What are “liver spots” or “age spots”?
• How do freckles develop?
• How important is heredity with freckles?
• What is the medical meaning of freckles?
• How can freckles be prevented?
• How can freckles be treated?
• The value of freckles?
• Freckles At A Glance
What are freckles?
Freckles are flat, tanned circular spots that typically are the size of the head of a nail. The spots are multiple and may develop randomly on the skin, especially after repeated exposure to sunlight. These are particularly common in persons of fair complexion on upper body skin areas like the cheeks, nose, arms, and upper shoulders. They may appear as young as at age 1 or 2.
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 black — but they are basically slightly darker than the surrounding skin. They tend to become darker and more apparent with sun exposure, and lighten in the winter months. While freckles are due to an increase in the amount of dark pigment called melanin, they are not due to an increase in the total number of pigment cells called melanocytes.
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 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 in people with light complexions and in some families, they are a hereditary (genetic) trait. Manay patients 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 may help to suppress the appearance of the some types of freckles.
1. 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 an basic type 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 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 freckles do tend to appear over time, they are not in themselves a sign of old age. Instead, they appear generally on sun-exposed areas, more so in people who have a genetic tendency to develop them. So, they are by no means purely a function of age.
These spots are just the lentigo-type freckles that are commonly seen on the skin of older adults with a history of sun exposure. Sometimes, older people who have these lentigo-type freckles also have raised, brown, crusty lesions called seborrheic keratosis in or around the same areas. Seborrheic keratosis 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 black. 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 keratoses.
How do freckles develop?
Freckles are thought to develop from a combination of genetic tendency and sun exposure in some individuals. Two people receiving the same sun exposure may not have an equal chance of developing freckles. Natural sunlight and artificial sun-tanning lights emit ultraviolet (UV) rays. After exposure to ultraviolet rays, the outer layer of the skin (the epidermis) thickens and the pigment-producing cells (the melanocytes) produce the pigment melanin at an increased rate. (This production of melanin may in fact give some protection against future sun exposure.)
Irrespective of skin color, freckling is caused by the uneven distribution of the melanin pigment in the skin. A freckle is essentially nothing more than an unusually heavy deposit of melanin at one spot in the skin.
Heredity and skin type are very important in the tendency to develop freckles. Freckles tend to be inherited genetically and are most common in individuals with fair skin and/or with blond or red hair.
Ongoing research in a rare disease called Xeroderma Pigmentosum has also confirmed the genetic tendency of freckles. Excessive freckles in dark haired individuals are quite common in this disease.Further, freckles are also found in skin folds like the underarms in another uncommon genetic disease called Neurofibromatosis.
What is the medical meaning of freckles?
True freckles pose essentially no health risk at all. They are all absolutely harmless. They are not cancerous and generally do not become cancerous. Rare concerns about freckles may arise when they are associated with other diseases like Xeroderma Pigmentosum and Neurofibromatosis or when they are confused with the following, more serious conditions:
Since we can not 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) 30
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 10am to 4pm
5. Seeking shade and staying indoors.
Several safe and effective methods are available to help lighten or reduce the appearance of freckles: Frequently, multiple or a combination of treatments may be required for best results. Not everyone’s skin may improve with similar treatments and freckles can easily recur with repeated UV exposures.
Some people like their freckles while others may be more bothered by their appearance. The cosmetic improvement of the skin is a frequent request among people with freckles. Freckles are desirable by some people who like the special character or uniqueness these give them.
• Freckles are usually friendly, small tan or light brown spots on sun exposed skin
• Freckles may be mistaken for moles and other skin growths..
• Freckles themselves are quite harmless and rarely develop into skin cancer.
• Freckles may be confused with more serious skin problems.
• Skin cancer may at times masquerade or hide as a freckle.
• Uncertain colored or pigmented spots should be examined by your physician or dermatologist.
• Effective treatments are available to help lighten or eliminate bothersome freckles.
For more information, please call (949) 582-7699 or visit the practice website at www.lagunaskincenter.com.
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