Freckles on the Face, Shoulders and Hands

What are freckles?

Freckles are circular multiple brown spots usually seen in people with fair complexion. These spots are usually about the size of a pinhead and often occurs as multiple spots localized to one part of the face, or sometimes through the face and upper body. Although the cheeks are most commonly affected, freckles can occur on any part of the body and in particular the areas which are exposed to sun. The shoulders, upper chest and back and arms are also commonly affected. Freckles are not a rash but occur due to clustering of melanin (skin pigments) on the skin. They are harmless (apart from cosmetic problem) and do not become cancerous. Treatment options include retinoids, bleaching creams, chemical peels and laser treatments.

Symptoms of Freckles

Symptoms of freckles include :

  • Appearance of circular, tiny (pin-head sized), tanned spots on the sun exposed part of the body namely cheeks, bridge of the nose, shoulder, upper arm even chest and back.
  • Most of the freckles are homogenous in color. Color of freckles differs from person to person. It usually ranges from reddish to brownish; even in some cases they may appear black.
  • Severity, both an increase in number and darkening of spots, occur with exposure to sun. Similarly avoidance of sun causes lightening of freckles.
  • Freckles commonly starts appearing in childhood and adolescence age group. Rarely infants may have freckles. In older age spontaneous disappearance of freckles may occur.
  • Freckles do not itch and are not raised.

Causes of Freckles

Sun and Melanin in Freckles

Freckles are actually a concentration of melanin (the skin pigment that helps to protect skin from harmful ultraviolet radiation) and not due to increased number of melanin producing cells (melanocytes). It is commonly thought that freckles originate due to an interplay between genetic predisposition towards freckles development and sun exposure. Due to exposure to natural sun light as well as artificial tanning UV lights the outermost layer of the skin (epidermis) become thick and there is increased production of melanin. In genetically prone persons increased melanin pigments become unevenly clustered on sun-exposed skin of the body leading to freckles.

Types of Freckles

Freckling more commonly occur in fair complexioned person especially with blond or red hair color. Mainly there are two types similar pigmented skin spots that are broadly referred to as freckles.

  • Ephelides are freckles that most people known and see. It is a flat topped reddish to brownish spots occurring predominantly during sun exposure and disappears spontaneously during winter and avoidance of sun. Regular use of sunscreens during sun exposure usually prevents appearance of this type of freckles. Incidence of these freckles may run in the family
  • Liver spots, also known as sun spots, are commonly seen on the back of the hand in older age group. Although it is a skin blemish that can be referred to as a freckle, it is not the freckles that is known to occur in the face of young people. These spots do not disappear during winter.

Risk Factors for Freckles

The risk factors for developing freckles includes :

  • Family history of freckles.
  • Prolonged sun exposure.
  • Exposure to artificial UV light for tanning.
  • Fair complexion.
  • Blonde or red hair and light colored eyes.

Freckles Treatment

Freckles are not harmful and do not require treatment. However, the cosmetic impact may prompt patients to seek treatment measures to at the very least lighten the freckles. These treatment options include creams, chemical peels, liquid nitrogen (cryosurgery) and laser therapy. No single treatment is effective to the same degree in every patient.

Creams for Freckles

  • Bleaching creams containing 2% hydroquinone are effective in lightening of freckles when used along with regular application of sunscreen and practising sun avoidance.
  • Topical retinoids (ointment, cream)with prolonged use may be beneficial. This drug is highly teratogenic (damage a developing fetus), and therefore should be used cautiously in women of reproductive age group who may not be aware when they are pregnant. It must be avoided in pregnancy.

Freckles and Sunscreens

Sunscreen creams are not a cure for freckles. However, it plays a major role in limiting the darkening of the spots particularly during the sunny summer months. A reputable brand of sunblock, with as least SPF 30, should be used on a daily basis. Sun exposure should be minimized and people with freckles should also avoid UV tanning beds.

References :

Posted by in Skin Hair and Nails

Leave a Reply