Freckles

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    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.

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What is the medical meaning of freckles?

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 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 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 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 with 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 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.

Medically Reviewed by a Doctor on 11/11/2015

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