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Written by Stephanie Booth, Shawna SeedMedically Reviewed by Zilpah Sheikh, MD on October 13, 2024

• What Are Freckles?
• Types of Freckles
• What Causes Freckles?
• Freckle Treatment
• Freckle Prevention
• Freckles vs. Sunspots
• Freckles vs. Moles
• Takeaways
• Freckles FAQs

6 min read

What Are Freckles?

Freckles are extra patches of coloring (or pigment) under your skin. Doctors call them ephelides. You have them because of the genes you were born with.

Freckles often show up during childhood, and you may continue to get more until you're in your 20s. They're most common in people with fair skin or red hair, but anyone can have them. If you have dark skin, your freckles may appear as darker brown spots.

Types of Freckles

There are two types of freckles: ephelides and solar lentigines. Although both are flat spots, they’re different in a few ways.

Ephelides:

• Are genetic.
• First show up when you’re around 2-3 years old, often after you’ve been in the sun.
• Are usually on your arms, chest, face, and neck.
• Can be red, dark brown, or light brown.
• Can go away as you age.
• May fade during the winter.
• Are usually about 1-2 millimeters in diameter or bigger.
• Have irregular borders that aren’t very defined.

Freckles can show up anywhere you have skin. Lip freckles are usually harmless. But if you notice changes, have the freckles on your lips checked by a doctor.

Your eyes also can have freckles. Eye freckles are called nevi, and they appear on the surface of your eye. If you're born with nevi, they're probably harmless. Ones that develop later in life are likely to be harmless as well, but your eye doctor should monitor them.

Freckles also can appear on and around your genitals. Penile freckles might cause you concern, but they're likely to be harmless. You can have your doctor check any unusual spots on your genitals to be sure. 

Solar lentigines:

• Are sometimes called age spots or liver spots.
• Show up as you age and are common if you’re 50 or older.
• Can be anywhere on your body that gets sun, including areas such as your back, chest, face, forearms, hands, and shins.
• Don’t fade or disappear.
• Can range from light yellow to dark brown in color.
• Show up because of sun exposure and aging.
• Have clear borders.

What Causes Freckles?

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

Too much sun may also cause your skin to become:

• Tanned
• Sunburned
• Blotchy

Freckle Treatment

Natural freckles don't need treatment, as they don't indicate a skin problem. 

How to get rid of freckles

If you don't like how your freckles look, treatments can help fade them. These include:

• Chemicals such as alpha-hydroxy acid (AHA) and trichloroacetic acid (TCA)
• Laser treatments
• Cryotherapy (skin freezing)
• Chemical peels
• Creams such as retinol, a form of vitamin A

A dermatologist can help you decide which treatment is best for you.

Do freckles go away?

As you get older, they may get lighter on their own or go away entirely, depending on what type of freckle they are. Freckles also may fade during the winter, when you have less sun exposure.

 

How to tell if a freckle is skin cancer

Almost all freckles are harmless, and cancerous freckles are rare. You should see a doctor if your freckles:

• Have jagged borders.
• Aren’t symmetrical.
• Are sore.
• Have a diameter of more than 6 millimeters (about the size of a pencil eraser).
• Become raised above your skin.
• Have dark patches or multiple colors.
• Start to grow or change size or colors.

A freckle can look odd without being skin cancer.

Freckle Prevention

You can avoid getting more freckles by protecting yourself from the sun. Here are some of the best ways:

• Always wear a water-resistant sunscreen with broad-spectrum protection and an SPF of 30 or higher (even when it’s not sunny).
• Never use tanning beds.
• Don’t get sunburned.
• Stay in the shade, especially from 10 a.m. to 4 p.m.

Freckles vs. Sunspots

You may confuse freckles and lentigines, which also are called age spots or liver spots. They can look tan, brown, or black and are common in people who are 50 or older. You can get them if you're younger, though.

Sunspots are caused by too much pigment stuck together in one area of your skin. This can happen after many years of spending a lot of time in the sun. Tanning beds can cause sunspots, too.

If you have sunspots, you could also see:

• More spots on parts of your body that get sunlight (like your hands, feet, face, and shoulders).
• Spots as large as a half-inch across.

Sunspots are harmless, but if you don't like how they look, prescription creams can lighten them. Sometimes, you can have them removed. Have a doctor check out any dark spots on your skin.

Freckles vs. Moles

You might mistake moles for freckles, but they're something different. Also called "nevi," moles form when a bunch of your skin cells clump together.

You can find moles anywhere on your body. For instance, you can have them on your scalp, between your toes, and under your nails.

Almost everyone has at least a few moles. Even having dozens is normal. You're more likely to have moles if you have light skin. They often appear when you're a child.

Moles may appear:

• Round
• Flat or slightly raised
• Tan, black, red, pink, blue, skin-toned, or colorless

Most moles don't need treatment. If you don't like how one looks, your doctor should be able to remove it with a short in-office procedure. Never try to remove a mole yourself. It can cause a scar or infection.

If you notice any changes to a mole, or if it gets itchy or starts to bleed, get it checked by a dermatologist. These can be early signs of skin cancer.

The doctor might send a small tissue sample of the mole to a lab for testing. If the test finds cancer cells, they'll remove the entire mole. Skin cancer is easiest to treat when you find it early.

Takeaways

Freckles — doctors call them ephelides — are patches of extra color in your skin. They're caused by your genes. They might get darker with more sun exposure. Another type of spot on your skin is a solar lentigine. Sometimes called age spots, solar lentigines are caused by the sun's rays. Most freckles and lentigines are harmless, even when they show up in unusual spots such as your lips. If you don't like how your spots appear, there are options for fading or removing them. If you're worried about a dark spot on your skin, have it checked by a dermatologist.

Freckles FAQs

Are freckles genetic or sun damage?

True freckles are genetic, though sun exposure can make them darker.

Which deficiency causes freckles?

Freckles (ephelides) are genetic, and what we sometimes call age spots (solar lentigines) result from sun exposure. However, hyperpigmentation (spots on your skin that are darker than others) can be a sign that you're not getting enough vitamin B12.

What race has freckles?

You're more likely to have freckles if you have fair skin, but anyone can get them. If you have a dark skin tone, freckles will appear as darker spots.

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