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.
Since we cannot change our own genetic component of freckling, our main prevention measures are aimed at sun avoidance and sun-protection,
including
use of sunscreens with SPF (sun protection factor) 30,
use of wide-brimmed hats (6 inches),
use of sun-protective clothing (shirts, long sleeves, long pants),
avoidance of the peak sun hours of 10 a.m. to 4 p.m., and
seeking shade and staying indoors.
Ideally, freckle prevention is more effective than later trying to remove freckles that have already developed. Freckle-reduction treatments are more difficult and not always satisfactory.
People with known hereditary tendencies of freckling should start sun protection early in childhood. Much of the sun and UV skin damage occurs often while children are under age 18.
Fair-skinned people who are more prone to freckling and sunburns are also generally more at risk for developing skin cancers. Freckles may be a warning sign of sensitive skin that is highly vulnerable to sunburn and to potential skin cancer.
How can freckles be treated?
Several safe and effective methods are available to help lighten or reduce the appearance of freckles: Frequently, multiple or a combination of treatments may be required for best results. Not everyone's skin will improve with similar treatments and freckles can easily recur with repeated UV exposures.
Bleaching or fading creams: Products containing hydroquinone and kojic acid can be purchased with and without a prescription. Higher concentrations of hydroquinone (over 2%) require a prescription. These products can help lighten freckles if they are applied consistently over a period of months. Bleaching or fading creams are most effective in combination with sun avoidance and sun protection.
Retinoids: Sometimes used in conjunction with other bleaching creams, tretinoin (vitamin A acid, Retin-A), tazarotene (Tazorac), adapalene (Differin) also may help lighten freckles when applied consistently over a period of several months.
Cryosurgery: A light freeze with liquid nitrogen in the physician's office can be used to treat some types of freckles. Not all spots respond to freezing or burning.
Laser treatment: Multiple types of lasers may help lighten and decrease the appearance of freckles safely and effectively. Like cryosurgery, this is a simple and safe procedure with a high success rate and a low risk of scarring or skin discoloration.
Photofacials or Intense Pulsed Light treatments are another method to lighten and remove freckles. This is not a true laser technique but an intense light source.
Chemical peels can also help lighten freckles and improve irregular pigmentation.
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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