Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
True freckles pose essentially no health risk at all. They are all absolutely harmless. They are not cancerous and generally do not become cancerous.
Rare concerns about freckles may arise when they are associated with other diseases like xeroderma pigmentosum and neurofibromatosis or when they are confused with the following, more serious conditions:
Lentigo maligna ("malignant freckle"): This is an uncommon fairly superficial skin cancer that generally occurs on the faces of older adults who have a history of considerable sun exposure. Over the course of months to years, this condition may, if untreated, develop into a more aggressive malignant variety called lentigo maligna melanoma. There are, of course, many hundreds of ordinary facial freckles for every one that is potentially malignant. A simple in-office test called a skin biopsy can help diagnose lentigo maligna.
Melanoma: This very dangerous form of skin cancer may appear even in young people and on parts of the body that are sun-exposed as well as those that are protected.. While the exact cause of melanoma is not entirely known, ultraviolet rays (particularly UVA) are known to play a part. Melanomas can arise from a previously normal mole or pigmented spot that has been present many years or lifelong. Melanomas can also arise from completely normal skin without an apparent preexisting mole. In comparison with benign (noncancerous) freckles, melanomas tend to be larger, darker, and have more irregular color and shape variations.. Most melanomas are actually flat and not raised as many people tend to incorrectly assume.
Basal cell carcinoma: This is the most common type of skin cancer. These are usually pearly, pink or reddish in color and may bleed easily. Pigmented basal cell carcinoma is a type of basal cell that may be confused for a freckle or seborrheic keratosis because of its brown or dark color. A simple procedure called a skin biopsy can help diagnose this growth.
A warning:
Anyone who has one or more uncertain pigmented spots should have their physician or dermatologist evaluate them. Even verbal descriptions and photographs cannot convey enough information for satisfactory self-diagnosis. As always, it is better to be safe than sorry.
The American Academy of Dermatology recommends a full-body skin examination for adults as part of a routine annual health exam. It is important to have any new, changing, bleeding mole or growth examined by your physician or dermatologist as soon as possible. Skin cancers are curable if diagnosed and treated at an early stage.
Skin cancer is the most common form of cancer
in humans. There are three main types of skin cancer; basal cell carcinoma and
squamous cell carcinoma (the nonmelanoma skin cancers), and melanoma.
Melanoma is a type of skin cancer which begins in skin cells called melanocytes and affects more than 53,600 people in the United States each year. These melanocytes can grow together to form benign moles which, after a change in size, shape, or color can be a sign of melanoma. Caused by sun exposure, early detection becomes extremely important to avoid a spread to other areas of the body. Diagnosis is confirmed through a biopsy of the abnormal skin and treatment depends on the extent and characteristics of the patient.
Moles are small skin growths that may appear flat or raised and are often tan, brown, black, reddish brown, or skin colored. They are typically about the size of a pencil eraser. There are three types of moles. Monthly skin self-exams are essential in the early detection of abnormal moles and melanomas.
Sun sensitivity (photosensitivity) is an inflammation of the skin induced by the combination of medications or substances and sunlight. The affect on the skin is redness, which looks similar to a sunburn. Generally, these reactions are either phototoxic or photoallergic. Phototoxic drugs are more common than photoallergic drugs. Symptoms of phototoxic reactions are a burning and stinging sensation and then redness. Symptoms of photoallergic reactions are itching, redness, swelling, blisters of the affected area. Treatment generally is discontinuation of the medication and topical application of creams.
Sunburn is caused by overexposure to UV radiation from the sun. UV rays can also damage the eyes. Repeated overexposure to UV rays also increases the risk for scarring, freckles, wrinkles, and dry skin. Symptoms of sunburn include painful, red, tender, and hot skin. The skin may blister, swell, and peel. Sun poisoning (severe sunburn) include nausea, fever, chills, rapid pulse, dizziness and more. Treatment for sunburn depends upon the severity. Sun protection and sunscreen for an individual's skin type is recommended to decrease the chance of sunburn.
Sunscreens are crucial for sun protection. Sun damage to the skin from exposure to ultraviolet rays is a risk factor for skin cancer and melanoma. To avoid sunburn, people should limit sun exposure during the peak hours of 10 a.m. to 3 p.m., wear protective clothing, and use a sunscreen. People with sensitive skin should use a sunscreen with an SPF of 30 or more.
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