Freckles are one of the most misunderstood skin markers. Sometimes a sign of beauty and vitality, sometimes a sign of ill health, we either love them or we hate them. They are endemic to some skin and hair color combinations (for instance redheads have more freckles typically than other hair colors). But what are freckles really, which ones are dangerous, and how do we go about treating them?

 

The Low Down On Freckles

Freckles are little specks of melanin. Melanin is a protein that causes pigment in the skin to protect it from damage by making it darker. It occurs when the sun’s rays or other UV radiation comes into contact with the skin. Caused by the cells melanocytes, melanin can show up evenly on some skin types causing tan, and on others, they are more uneven, or clustered; in which case freckles form. 

These little spots of melanin are more common on redheads, as they are caused by the same gene, MC1R. The gene perches on melanocytes and controls the pigment balance in both hair and skin. When MC1R is working the way it normally does, it converts any pigment the body produces into eumelanin, which is responsible for black and brown hair and skin colors. When the MC1R gene is “broken,” it allows a rarer type of human pigment, pheomelanin, to build up in the body. Pheomelanin causes reddish hair and the rusty look of most freckles. Variations of the MC1R may also control the number of freckles people have. But MC1R isn’t the only gene causing freckles. About a decade ago, scientists discovered another gene responsible for freckles in Chinese populations. Other genes may be involved too—scientists have yet to unravel all of the genetic causes behind freckles, which occur in a variety of ethnic groups. Regardless of the precise genetic mechanism, freckles are always a family affair: Parents pass on the likelihood of freckling, as well as its locations across the body. (Source).

Sometimes freckles are an indicator that someone’s skin is unhealthy, potentially cancerous or precancerous. It is important to know so that you can guide your clients if you see something of note, whether you think it is something dangerous or something to just keep an eye on.

 

Recognizing What Freckles are Dangerous

A lot of people get confused about what a freckle is, versus a mole, versus a melanoma. Most freckles and moles are harmless as stand alone skin markers. However, not all are. As noted by Cambridge University Hospital:

Freckles are small usually pale brown areas of skin, which are often temporary and are usually caused by exposure to the sun. Moles are areas of darker pigmented (brown or brown/black) on the skin, they are long-lasting and are only indirectly associated with exposure to the sun. Both freckles and moles are very common in all peoples of the world but they are more obvious in people who have lighter coloured skin. There are rare types of freckles (usually clustered around the mouth) that are part of a genetic syndrome called Peutz Jeghers Syndrome. These are quite easy for a doctor or dentist to diagnose in a person or family…. 

Moles are very common and therefore ‘normal’ for most people: the average adult has between ten to forty at any time. Moles are collections of melanocytes that are producing melanin to give a concentrated ‘patch’ of colour in the skin. Some people are born with a few or many moles and some families have more moles than others. We think others develop moles as a response to sun exposure. The type of moles that doctors are most interested in is those that can become a type of skin cancer (melanoma).

You can have any number of moles, and most never become cancerous…. Some moles do last for your lifetime, others come and go but usually over years.  Quite often a mole begins as a small, flat spot and over time, becomes raised. It might then flatten again, become paler and even disappear altogether. Some moles develop and change their appearance quickly – these are the ones to be most concerned about. Doctors encourage people to keep an eye on their moles and ask them for advice when a mole:

• Changes shape: especially if it has irregular edges
• Changes size: especially if it gets larger
• Bleeds easily

Obviously, before anyone would be diagnosed with a melanoma a biopsy would be done. Any cancerous, pre-cancerous, or unsightly moles and freckles would likely trigger a person to want them to be removed. The reduction or lightening or total removal of skin spots is one of the most common requests that we see. Other than surgical removal, there are options for treating freckles.

 

Treating Freckles

The easiest way to treat freckles is to reduce the skin’s exposure to the sun. According to Medical News Today, the American Academy of Dermatology (AAD) recommends 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.

Lots of people try lots of home remedies for lightening skin. These work to some extent, such as using the juice of lemons, honey or aloe vera. There are also a number of over-the-counter products that are accessible to anyone. However, these will not work as well as the prescription-strength medications that we can offer to patients or the procedures we can do to help them in a medical spa or clinic setting. The best approach is with laser skin resurfacing, or laser pigment removal. It has only been about a year since it has been on the market, but the American Academy of Dermatology has put their full vote of support behind the PiQo4 laser, as noted by Allure Magazine:

On a basic level, laser treatments, which use high-energy light beams to treat skin, work in two ways. For deeper pigmentation, such as melasma or tattoos, lasers can shatter pigment deposits underneath the skin. For surface-level treatment, “the laser works by punching microscopic holes in the skin, creating a controlled wound,” Joshua Zeichner, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, previously told Allure. “As the skin heals from this controlled injury, it does so in a more healthy and cosmetically elegant manner.”

The same principles apply to the removal of freckles, and even moles, for those who prefer the little sun spots not be on their skin.