Freckles are a collection of concentrated melanin that are most often visible in people with a lighter complexion. Triggered by sun exposure, freckles appear randomly and are basically not considered a serious condition.
What are freckles?
Freckles spread on areas of skin such as cheeks, nose, arms, shoulders with increased sun exposure and are usually uniform in color. There are two different types of freckles. Simple freckles (ephelides) are round spots that vary in color from reddish to yellow to black and are typically about 2-3mm in size. Sunburn freckles (lentigines) are often darker, have irregular jagged edges, and may be larger than usual. These include “liver or age spots,” which are mistakenly attributed to problems with the liver. With age, these freckles can begin to proliferate. These benign skin growths are called seborrheic keratoses. Freckles spread to areas of skin such as cheeks, nose, arms, shoulders with increased sun exposure and are usually uniform in color. Freckles occur less frequently in infants and young children, but more frequently from the onset of puberty.
Causes
Freckles are an accumulation of the darker pigment melanin and are not due to an increase in the total number of melanocytes (pigment-producing cells). Natural sunlight and the artificial light from tanning beds contain ultraviolet radiation. When this hits the outer layer of skin (epidermis), the melanocytes produce the pigment melanin at an increased rate to protect the skin from the radiation to a certain extent (sunburn). People with blond or red hair, light eyes and fair skin are particularly susceptible to the damaging effects of UV rays. Regardless of skin color, however, freckles are caused by the uneven distribution of the pigment melanin in the skin. Several studies of twin pairs with a remarkable similarity in the total number of freckles suggest that the tendency to freckle is inherited.
Diseases with this symptom
- Age spots
- Skin cancer
- Sunburn
Diagnosis and course
In essence, freckles do not entail any health risks and are usually not malignant. Pathological accumulations of freckles are described by the diseases xeroderma pigmentosum and neurofibromatosis. So-called malignant freckles (lentigo maligna) refer to a superficial skin cancer that forms on the faces of older people who have been exposed to large amounts of sunlight for a long time. A simple skin biopsy can help diagnose lentigo maligna. Melanomas are larger, darker, and are more irregular in color and shape. The most common form of skin cancer is called basal cell carcinoma: it is usually pearly, pinkish or reddish in color and can bleed easily. A pigmented basal cell carcinoma can be mistaken for a freckle because of its dark color. Generally, it is recommended to consult a doctor or dermatologist if pigmented spots are unsafe to rule out the diagnosis of skin cancer.
Complications
Freckles are not a disease, which is why they do not require treatment. There is also no method to get rid of freckles permanently. In some cases, the affected people are dissatisfied and feel that they are not attractive. This can lead to lowered self-esteem and further psychological problems or depression. However, this occurs only in very rare cases, as freckles are currently considered fashionable. It often happens that freckles become stronger or fade away again in connection with sun exposure. This process is also completely normal and depends on the melanin content in the skin. The melanin content in the skin changes with stronger sunlight, so that the freckles become stronger and fade again in winter. Therefore, there is no need to see a doctor for freckles. There is also no treatment for the symptom. If a person does not like the freckles, they can be covered up with make-up.Often freckles cover not only the face, but also the shoulders or arms. Freckles on these areas are also completely natural, so no treatment is necessary here either. Since there is no treatment against freckles, no complications can occur.
When should you go to the doctor?
There is no need to see a doctor for freckles. It is a common symptom, which is not medically dangerous to health and does not lead to any complications or discomfort. It is also perfectly normal that the number of freckles changes in the summer and winter months and does not remain constant. Especially in the summer time, freckles can appear more frequently and cover the body. Treatment at the doctor is not directly possible in this case. However, the patient should be careful not to confuse the freckles with a birthmark. As a rule, moles should be treated and examined when they change. The change can be either in shape, size or color. Therefore, if the patient notices any of these changes, a doctor should be consulted. Usually, a quick and uncomplicated treatment is possible, so that there are no further complaints or complications. If the affected person is dissatisfied with the freckles and thus suffers from a lowered self-esteem, it is possible to treat the freckles cosmetically. In this case, a cosmetician or a dermatologist can be consulted. However, in many cases, cosmetic products can also be used to cover the freckles.
Treatment and therapy
There are now several safe and effective methods for lightening or reducing the appearance of freckles. Multiple treatments or a combination of applications are often required to achieve long-term results. Products containing hydroquinone and kojic acid can be purchased with (hydroquinone concentration above 2%) and without a prescription. Used consistently over a long period of time and optimally combined with sunscreen creams, such products can lighten freckles. Other bleaching agents are so-called retinoid-containing creams such as tretinoin (vitamin A acid, retin-A), tazarotene or adapalene. In medical practices, iced nitrogen is sometimes used to freeze certain freckles (cryotherapy). Laser treatment is safe and effective. Like cryosurgery, this procedure has a high success rate with a low risk of scarring or skin discoloration. Light treatments have also proven to be a successful treatment method. In the case of irregular pigmentation of freckles, chemical peels can also be used.
Outlook and prognosis
Freckles are not a symptom that is dangerous to health. For this reason, freckles are not treated in any special way. They are a common symptom in many people and can appear due to increased exposure to the sun. Especially in summer the number of freckles often increases, in winter it decreases accordingly. It is not necessary to see a doctor for this symptom. If the patient with the freckles does not find himself attractive, there is usually a decreased self-esteem. These thoughts may result in psychological problems and should be treated by a psychologist. Medical treatment against the freckles themselves is not possible. However, they can be made over with care products and thus concealed. In society, however, freckles are accepted and are not perceived as particularly unusual. The freckles are genetically predisposed in many people and can therefore appear all over the body without certain regions being preferentially covered. Whether freckles will remain on a person throughout life or disappear over time cannot be universally predicted.
Prevention
Fair-skinned people, who are more prone to pigmentation and sunburn, are at higher risk of skin cancer in any case. Since one’s genetic preference for freckles cannot be influenced, appropriate measures should be taken from childhood to avoid strong sun exposure.These include using sunscreen with a SPF of 30 or higher, wearing a wide-rimmed head covering, wearing long but airy clothing, and avoiding direct sun during midday hours.
Here’s what you can do yourself
There is usually no self-help for freckles. However, this symptom is not a medical limitation that could be dangerous for the body. For this reason, freckles do not need to be treated. For many people, freckles appear especially in summer when the sun is strong. For this reason, the affected areas of the skin need special protection. It is advisable to cover these areas with clothing and always apply sufficient sunscreen. This will also prevent sunburns. Direct sunlight should also be avoided. It is common for freckles to diminish somewhat during the winter months. However, this behavior may differ in different people. If the patient is unhappy or uncomfortable with the freckles, cosmetic care products can be used to touch them up. Here there are covering creams and make-up in the drugstore or pharmacy. In the case of psychological problems or a lowered self-esteem due to freckles, conversations with family, friends or one’s partner often help. In case of freckles, no further complaints or complications occur and the symptom is harmless. However, the patient should also keep an eye on moles and have them examined by a doctor immediately if they change.