Freckles: Causes, Identification, And Risks - Medical News Today

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Medical News TodaySubscribeWhat to know about freckles

Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Beth Sissons — Updated on November 9, 2023

Causes
Are freckles dangerous?
Freckles, sun spots, and moles
Prevention
Home remedies and treatments
When to see a doctor
Summary

Freckles are small, marks on the skin. Genetics and sun exposure are the primary causes of freckles. They can appear similar to some types of skin cancer. A person should seek medical advice about any changes to freckles.

Some people are more likely to get freckles than others, depending on their genes and skin type. If a person is genetically more likely to develop freckles, exposure to sunlight can make them appear.

Freckles are common in children and may disappear or become less noticeable as they grow up.

In this article, we look at what causes freckles, how to distinguish them from other similar marks, ways to remove or lighten them, and when to see a doctor or a skin doctor called a dermatologist.

What causes freckles?

a woman with freckles holding a glass to her eye — Maja Topcagic/Stocksy

Freckles appear when melanin, the pigment that gives skin its color, builds up under the skin. Freckles may look brown, red, or tan.

Sun exposure and genetic factors make some people more likely to develop freckles:

Sun exposure

A person’s skin cells produce extra melanin to protect the skin from sun damage. This is why freckles tend to appear after sun exposure.

Freckles can appear over a large area of skin and can reappear or become darker in the summer months. Freckles often fade or disappear in the winter months, when new skin cells replace old cells.

Freckles develop on areas often exposed to sunlight, such as the:

face
arms
neck
back
chest

Genetics

Genetics also play a leading role in who is more likely to develop freckles based on which type of melanin their body produces.

The body can produce two types of melanin called pheomelanin and eumelanin. Eumelanin protects the skin from UV rays, but pheomelanin does not.

The type of melanin the body produces depends on a gene called MC1R.

People with dark hair, eyes, and skin usually produce mostly eumelanin and are less likely to develop freckles.
People with red, blonde, or light brown hair and who have light-colored skin and eyes usually produce mainly pheomelanin and are more likely to develop freckles.

Are freckles dangerous?

Freckles are not dangerous. However, as people with freckles have skin that is more sensitive to sunlight, they should take extra care to protect their skin from the sun.

How to identify freckles, sun spots, and moles

Freckles can look very similar to other marks that develop on the skin. For example, they can look like sun spots, also known as age spots, or liver spots.

Sun exposure is a primary cause of both freckles and age spots. Age spots are typically larger than freckles, are more clearly defined, and tend to appear in older adults.

While freckles are more widespread on people with light-colored hair and skin, age spots develop on people with a wider range of complexions.

Moles are usually present from birth, but people can develop them throughout childhood and teenage years. Moles are generally darker than freckles and can be flat or raised off the skin.

This table shows the differences between common marks on the skin:

Freckles	Sun spots	Mole
Appearance	Flat, can appear in clusters over a large area	Flat, can appear in clusters	Flat or raised, can appear on their own or in groups
Cause	Genes and exposure to sun	Exposure to sun	When skin cells grow in clusters
At which ages do they appear?	Can first appear at 2–3 years old	More common in people aged 40 or older	From birth, or during childhood and adolescence
Where can they appear on the body?	Areas of sun-exposed skin, commonly the face, neck, chest, arms, back	Areas of sun-exposed skin, typically the face, hands, arms, shoulders, back	Anywhere on the body
Shape	Irregular shape with well-defined edges	Well-defined edges	Round or oval, well-defined edges
Color	Tan, brown, or red	Tan, brown, or black	Light to dark brown, or black
Size (diameter)	1–2 mm or larger	2 mm or larger	Usually less than 6 mm
Changes to expect	Can fade in winter and become darker in summer	Will stay the same; may get darker if left unprotected in sunlight	Will stay the same; can sometimes disappear over time

Preventing freckles

People can prevent or reduce the appearance of freckles by protecting their skin from the sun.

Protecting the skin from sunlight will not reduce the appearance of existing freckles, but it can prevent new freckles from forming.

The American Academy of Dermatology (AAD) recommend the following tips to protect the skin in sunlight:

wearing a water-resistant sunscreen with UVA and UVB protection, and an SPF of 30 or higher
covering up with long sleeves, a hat, and sunglasses
staying in the shade when the sun is strongest, between 10 a.m. and 2 p.m.
reapplying sunscreen every 2 hours when outside or after swimming or sweating
avoiding tanning beds

Home remedies and treatments

Freckles are harmless and do not need treatment.

However, if people want to remove or lighten freckles for cosmetic reasons, some treatments can reduce their appearance.

Over-the-counter treatments

A 2012 study showed that products containing trichloroacetic acid (TCA) and phenol are effective in lightening freckles. A variety of topical creams and spot peels contain these compounds.

Other compounds that may help to fade freckles include:

alpha hydroxy acids
azelaic acid
cysteamine
vitamin C
retinoids

People can also opt for medical procedures to remove dark spots for cosmetic reasons. These include laser therapy and chemical peels.

All of these treatments can cause side effects, such as scarring. Anyone considering treatments for freckles should discuss all their options with a doctor.

Home remedies

Some people find that certain natural products can lighten their freckles, although these methods are not scientifically proven.

Lemons: Apply a small amount of lemon juice to cotton wool and wipe over the skin. The Vitamin C in the lemon juice may help to lighten dark spots, although it is unlikely to be a high enough concentration to make a dramatic difference.
Honey: Spread a thin layer of honey on to the skin. Leave it for 5 to 10 minutes, then wash off with warm water. Honey has antioxidant properties, which may help to lighten freckles over time.
Aloe vera: Aloe vera contains salicylic acid and aloin. This may help to fade freckles. Use aloe vera from the leaf and apply to the skin.

Using these natural products on your skin is unlikely to cause any side effects, but it is best to do a patch test on a small area of skin first. If it causes any skin irritation, stop using the product.

When to see a doctor

Freckles are harmless, but they can sometimes look similar to some types of skin cancer. If people notice any changes in their skin, they should see a doctor, who will be able to check the skin for anything unusual.

People who have fair skin that freckles or burns easily may be at a higher risk of developing skin cancer. They should, therefore, take extra care when going out in the sun.

People should see a doctor if a mole, freckle, or sun spot:

itches
bleeds
grows
changes shape
looks different to those around it

People can also use the ABCDE guide to check spots on their skin. Look for:

Asymmetry — does one half looks different to the other half?

Border — does it have poorly defined or scalloped edges?

Color — is it a variety of shades of brown, black, or tan?

Diameter — is it bigger than the size of an eraser on the end of a pencil?

Evolves — has it changed shape, size, or color?

If people have a spot on the skin that matches one or more of the above signs, they should see a dermatologist as soon as possible.

Summary

Freckles are harmless marks on the skin caused by genetics and exposure to sunlight. If people have freckles, they will need to take extra care of their skin in the sun.

If people have any concerns about any new marks or changes to their skin, they should see a doctor or dermatologist who can check the skin for anything unusual.

Dermatology
Genetics
Pediatrics / Children's Health

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chan, B. (2014). Solar lentigohttps://www.dermnetnz.org/topics/solar-lentigo/
Chemical peels. (n.d.)https://www.asds.net/skin-experts/Skin-Treatments/Chemical-Peels
How can I tell if I have skin cancer? (n.d.)https://www.aad.org/public/diseases/skin-cancer/how-can-i-tell-if-i-have-skin-cancer
Laser/light therapy. (n.d.)https://www.asds.net/skin-experts/Skin-Treatments/Laser-light-Therapy
MC1R gene. (2018, October 16)https://ghr.nlm.nih.gov/gene/MC1R
McLoone, P., Oluwadun, A., Warnock, M., & Fyfe, L. (2016, August 4). Honey: A therapeutic agent for disorders of the skin. Central Asian Journal of Global Health, 5(1), 241https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5661189/
Moles. (n.d.)https://www.aad.org/public/diseases/bumps-and-growths/moles
Mradula, P. R., & Sacchidanand, S. (2012, October–December). A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles. Journal of Cutaneous and Aesthetic Surgery, 5(4), 261–265https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560166/
Oakley, A. (2016, February). Ephelishttps://www.dermnetnz.org/topics/ephelis/
Praetorius, C., Sturm, R. A., & Steingrimsson, E. (2014, February 12). Sun‐induced freckling: Ephelides and solar lentigines. Pigment Cell & Melanoma Research, 27(3)https://onlinelibrary.wiley.com/doi/full/10.1111/pcmr.12232
Prevent skin cancer. (n.d.)https://www.aad.org/public/spot-skin-cancer/learn-about-skin-cancer/prevent
Sarkar, R., Arora, P., & Garg, K. V. (2013, January–March). Cosmeceuticals for hyperpigmentation: What is available? Journal of Cutaneous and Aesthetic Surgery, 6(1), 4–11https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663177/
Skin cancer fact sheet. (2017, January)https://www.cancer.org/content/dam/cancer-org/cancer-control/en/booklets-flyers/skin-cancer-fact-sheet.pdf
What are the symptoms of skin cancer? (2018, June 26)https://www.cdc.gov/cancer/skin/basic_info/symptoms.htm

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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — Written by Beth Sissons — Updated on November 9, 2023

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