Q & A: Freckles and Your Skin

Ever wonder about those tiny little dots on your body? Why do you get freckles? Why do some people tend to have more? And can you really have matching freckles with your bestie?

These little specks on your skin are usually harmless and most commonly start to appear on children and teens. Freckles can clue you in about how your skin has reacted to sun, age and even your genetics. (But even if you weren’t genetically wired to be freckly, makeup and tattoos can usually give you the fresh face of freckles you’ve always dreamed of. Who knew?)

Here dermatologist, Melissa Piliang, MD, offers some truths about naturally occurring freckles.

Q: What are freckles?

A: When your skin is exposed to the sun, your body responds by making melanin pigment. That’s responsible for the color of your skin and how easily you tan. With a freckle (aka an ephelides), the body makes melanin pigment, but it makes a little too much in one area – resulting in a freckle! In other words, freckles are triggered by the sun, but it depends on the type and amount of melanin levels in your skin. People with blonde or red hair and fair skin tend to have melanin that makes them more prone to getting freckles.

Q: Are you born with freckles?

A: Nope! Most people with freckles usually start to see them come out around age 2 or 3 and continue into young adulthood. Freckles are from the sun – almost like a modified tan. Most people with freckles will notice that they fade in the wintertime when there is less sun exposure.

Q: Do you get more freckles as you age?

A: Actually no, you tend to get fewer the older you get. Your skin doesn’t respond to the sun the same way as it did when you were younger. You can, however, get solar lentigines (also known as sun spots or age spots), which are sun-induced brown spots, usually appearing as a patch of darken skin. They typically appear on body areas that have a history of repeated sun exposure ― like your face, shoulders, chest or back of your hands. They’re most common after age 40 but could appear in younger people depending on UV exposure history.

Solar lentigines, rather than being a tanning response like a freckle, show sun damage when looked at through a microscope. They are a skin reaction from chronic sun exposure.

Q: Why do some people have more freckles than others?

A: Freckles have to do with the type and amount of melanin in the skin. Typically, people with red or blonde hair or light colored skin have more “pheomelanin,” which is associated with freckles.

Q: Is there ever a point you should worry about freckles?

A: If you’ve noticed for years that you tend to have freckles in the summer and that they fade in the winter, those types of freckles probably won’t turn into skin cancer. But keep in mind that normal freckles are light brown and completely flat. If you have new spots that are raised, that bleed or are darker in color (like blue or black) then get them checked out. Regular freckles are 1 to 2 millimeters, so keep an eye out for anything that grows.

Q: What’s the difference between a freckle and a mole?

A: Freckles are just the increased melanin pigment in the outer layer of the skin. Moles, on the other hand, are from the increased amount of melanocytes. Those are the same skin cells that produce melanin, but are typically found at the bottom layer of the skin. Moles are slightly raised and generally bigger than most freckles. But because moles have active cells, it’s a good idea to keep an eye out for any changes.

Q: If you have a lot of freckles do you need different skin care?

A: No, because freckles are harmless. But realize they are a sign that you’ve had sun damage to your skin. You should always wear sunscreen, but particularly if you have light or red hair or are fair-skinned.

Q: Can you prevent freckles?

A: Remember that freckles are triggered by the sun. So if you’d like to prevent more from appearing on your skin, follow these sun safety guidelines:

• Seek shade – especially during the hours of 10 a.m. and 4 p.m.
• Avoid tanning beds and getting sunburned
• Cover up exposed body parts from the sun’s rays and wear a hat to protect your face
• Always wear sunscreen correctly
• Examine your skin and keep an eye out for any changes

Q: Is there a way to get rid of freckles?

A: Freckles should fade when you’re not in the sun and you get fewer of them as you age. But there are things that can help freckles fade faster if you’re concerned about how they look. Glycolic acid and other alpha hydroxy acids help to remove the outer layer of the skin where the discoloration resides. You can also ask your dermatologist about certain chemical peels and laser treatments that might also help to fade freckles. There are even some topical prescription treatments available as well. Keep in mind, though, that you can fade freckles ― but not completely remove them.