Freckles, or ephelides, are common noncancerous skin lesions. Many dislike them for cosmetic reasons or feel self-conscious about them.
If freckles cause distress and you want to remove them, various treatment options are available based on budget, risks, and time commitment. Read on to learn how you can have your freckles removed.
What is a freckle?
Freckles are common, noncancerous skin lesions that have a predilection for sun-exposed areas of the body. These flat, tan-brown lesions are 1–2 mm and appear on the face, neck, chest, arms, and back. They begin to appear around age 2 or 3 and often disappear after 20 years of age. Freckles become more pronounced in summer, with increased sun exposure, and may fade in winter.
What causes freckles?
An increase in melanin production by melanocytes in the top layer of the skin (epidermis) leads to the appearance of freckles. UV rays from the sun trigger melanin production as a protective mechanism. However, exposure to UV light also leads to freckle formation.
Genetics also plays a role in the appearance of freckles. Fair skin types are more at risk for developing them when exposed to the sun, so people with blonde or red hair tend to have more freckles.
How to prevent freckles
The easiest way to combat freckles is by preventing them. Sun protection and avoidance are crucial to prevent freckles, as well as wrinkles and skin cancers. In addition to sun avoidance, you should also avoid tanning beds, which emit UV light and cause freckles.
Here are some good sun protection tips:
Sunscreen. Use broad-spectrum sunscreen with SPF 50 daily.
Water. Select a water-resistant sunscreen if you are swimming or sweating.
Timing. Apply chemical sunscreens, like avobenzone or oxybenzone, 30 minutes before sun exposure. Unlike chemical sunscreens, you can apply physical sunscreens with zinc oxide or titanium dioxide immediately before sun exposure.
Reapply. Reapply sunscreen every 1–2 hours if you are in the sun.
Clothing. Wear sun protection clothing with UPF 50, wide-brimmed hats, and UV-protecting sunglasses.
Time of day. Avoid peak times of day for sun exposure (10 a.m. – 4 p.m.).
Shade. Seek shade to protect you from the sun. Consider using an umbrella.
Tan responsibly. Use a spray tan if you want to look tan.
Ways how people can remove freckles
Since freckles are harmless, you do not need to remove them unless they bother you cosmetically. There are various treatment options available. It is best to discuss treatment with a board-certified dermatologist who can select the correct treatment for you.
Chemical peels remove the top layers of the skin that contain the freckles to reveal lighter, smoother skin. Depending on the depth of the peel, they can require weeks of downtime. Common side effects include redness, swelling, crusting, itching, and stinging. There is also a risk of scarring and infection.
Several laser treatments can get rid of freckles. Some lasers target just the pigment in the skin, like IPL, while others remove layers of the skin to remove freckles, like CO2. The more invasive the laser, the higher the risk of scarring and infection.
Cryosurgery uses a very cold liquid (liquid nitrogen) to destroy the pigment-producing cells to remove the freckles. There is a higher risk of hypopigmentation and scarring with cryosurgery, making it a less desirable treatment option for darker skin types. Some patients experience blistering or bleeding after the treatment.
Microneedling utilizes a device with numerous tiny needles to cause microinjuries to the skin to break up the pigment. It stimulates your body to repair itself and remove the pigment. Many physicians combine it with platelet-rich plasma or platelet-rich fibrin to enhance the effects.
Some prescription creams can lighten or remove freckles, such as retinoids (tretinoin, tazarotene, and adapalene), azelaic acid, or hydroquinone. Some creams combine retinoids and hydroquinone for faster results. These are not appropriate for women who are pregnant or breastfeeding.
There are several effective over-the-counter creams for freckle lightening or removal, such as vitamin C, kojic acid, adapalene, licorice, and glycolic acid. These creams may take several months to see the positive effects, so patience is required. Some products combine several of these ingredients to hasten the results.
Natural remedies to remove freckles
While there are anecdotal reports of the positive results from natural freckle removers, no studies corroborate these findings. Results from these ingredients may be slow to appear, or nothing may happen. Some of these products may irritate the skin, especially if you have sensitive skin. It is best to discuss this with your dermatologist first.
Natural remedies include:
Tips to cover freckles
There is no medical reason to have your freckles removed. Many are self-conscious about them at certain times. If there are occasions, such as a party or business meeting, when you do not want anyone to see them, there are ways to cover freckles or make them less visible.
Here are some products to help cover freckles:
When should I be concerned about freckles?
Freckles are not cancerous and do not become cancerous, so you do not need to worry about them. They are, however, a sign that you are getting sun. Too much sun can lead to premature skin aging, which results in brown spots, wrinkles, and sagging skin. Cumulative sun also causes skin cancers, some of which are deadly. Always be sure to use daily sunscreen and practice good sun protection to prevent damage from the sun's radiation.
While freckles are benign skin lesions, many dislike them for cosmetic reasons. If you want to get rid of your freckles, there are many treatment options, such as professional creams and treatments, over-the-counter creams, and natural products. You must discuss these options with your dermatologist first to see which is best for you and your skin type.