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 randomly on the skin, especially 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 and in some families, they are a hereditary (genetic) trait.
Most freckles on a person’s skin are usually uniform in color. On different people, freckles may vary somewhat in color — they may be 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 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.
How do freckles develop?
Freckles are thought to develop as a result of a combination of genetic tendency (inheritance) and sun exposure. Two people receiving the same sun exposure may not have an equal chance of developing freckles. 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.
Of course, people differ a great deal in their reaction to sunlight. To take an extreme example, there is no pigmentation in the skin of an albino because of a defect in melanin metabolism. On the other hand, people with dark complexions are relatively less sensitive to sun exposure than fair-skinned people. However, people with dark skin are not entirely resistant to the effects of the sun, and they, too, can become sunburned with prolonged exposure. People with blond or red hair, light-colored eyes, and fair skin are especially susceptible to the damaging effect of UV rays.
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.
How important is heredity with freckles?
Heredity and skin type are very important factors for 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.
Research in twin siblings, including pairs of identical twins and pairs of fraternal (nonidentical) twins, have found a striking similarity in the total number of freckles found on each pair of identical twins. Such similarities were considerably less common in fraternal twins. These studies strongly suggest that the occurrence of freckles is influenced by genetic factors. In fact, the variations in freckle counts appear to be largely due to heredity.
Ongoing research in a rare disease called xeroderma pigmentosum has also confirmed the genetic tendency of freckles.
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.
How can freckles be prevented?
Since we cannot change our own genetic component of freckling, our main prevention measures are aimed at sun avoidance and sun-protection, including
- use of sunscreens with SPF (sun protection factor) 30,
- use of wide-brimmed hats,
- use of sun-protective clothing (shirts, long sleeves, long pants),
- avoidance of the peak sun hours of 10 a.m. to 4 p.m., and
- seeking shade and staying indoors.
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.
How can freckles be treated?
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 will improve with similar treatments and freckles can easily recur with repeated UV exposures.
- Fading creams: Products containing kojic acid can help lighten freckles if they are applied consistently over a period of months. Bleaching or fading creams are most effective in combination with sun avoidance and sun protection.
- Retinoids: Sometimes used in conjunction with other bleaching creams,tretinoin, tazarotene, adapalene also may help lighten freckles when applied consistently over a period of several months.
- Laser treatment: Multiple types of lasers may help lighten and decrease the appearance of freckles safely and effectively.
- Photofacials or Intense Pulsed Light treatments are another method to lighten and remove freckles.
- Red Light emitting Diode therapy is also used to complement lasers and Intense Pulsed light.
Spot Testing Before Treating Freckles To find Which Laser is Suitable For Treating Freckles
Freckles are treated by different lasers and lights. The various tools used are