Freckles can be charming, and many people love theirs. Others would rather have a more even tone. Either way, it helps to know what they are, why they change with the seasons and what can be done.
What are freckles?
Freckles (doctors call them ephelides) are small, flat, light to mid-brown spots, usually a few millimetres across, on skin that gets sun: the face, especially the nose and cheeks, the shoulders, arms and upper back. They often appear in childhood, darken in summer and fade in winter.
They are harmless. A freckle is simply an area where pigment cells make more melanin in response to ultraviolet light; the number of pigment cells is normal.
Why some people freckle
- Genes: freckling runs in families.
- Sun: UV light switches on pigment production, so freckles darken with exposure.
- Skin type: freckles are commonest in lighter skin, but brown skin can freckle too.
Freckles or something else?
Not every brown spot is a freckle, and the treatment differs:
- Sun spots (solar lentigines) appear later in life, are often larger and do not fade in winter.
- Melasma forms larger, blotchy patches on the cheeks, forehead or upper lip, linked to hormones, heat and sun. Strong lasers can make melasma worse, so it needs a different plan. See melasma.
- Moles are often raised or darker. A spot that is changing, irregular, bleeding or very different from your others should be checked by a doctor.
Step one: sun protection
Whatever else you do, daily sun protection is the foundation. It stops freckles darkening and prevents new ones.
- A broad-spectrum sunscreen of SPF 30 or more every morning, reapplied when outdoors.
- Hats, shade and sunglasses in strong midday sun.
- Tinted sunscreens containing iron oxides also help against visible light, which can deepen pigment in brown skin.
Creams and serums
A dermatologist may prescribe or suggest:
- retinoids, which speed up skin turnover;
- azelaic acid, vitamin C, niacinamide and similar brighteners;
- short, supervised courses of stronger lightening creams in some cases.
These work slowly, over two to three months, and only with sun protection.
Peels
Superficial chemical peels such as glycolic or salicylic acid remove the top layers of skin where some of the pigment sits. A series of gentle peels can lighten freckles with little downtime. See chemical peels.
Lasers
Pigment lasers send very short pulses of light that break pigment into tiny particles, which the body then clears.
- Q-switched Nd:YAG lasers and picosecond lasers are commonly used for freckles and sun spots.
- Treated spots may darken and flake for about a week before they fade.
- One to a few sessions are usually needed.
- On brown skin, settings are chosen carefully to avoid temporary darkening or lightening, and a test patch may be done first.
Read about our pigmentation treatment, Q-switch laser toning and pico laser.
The bottom line
Freckles are harmless and treating them is a personal choice. If you would like them lighter, start with sunscreen, then talk to a dermatologist about creams, peels or a pigment laser, and keep up the sun protection afterwards so the result lasts.
