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How can we know if a freckle needs to be treated?

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Freckles or ephelides are a benign skin blemish lesion caused by an increase in melanin pigment in the epidermis. These small spots on the skin appear most commonly on the face, shoulders and upper back, areas that tend to be more exposed to solar radiation. In general, freckles are benign, but there are some signs that alert us to treat a freckle.

Types of freckles and moles: genetic origin

Freckles can be divided into two types, depending on their origin. On the one hand, there are freckles that appear from birth, called congenital nevi. On the other hand, there are freckles that appear during childhood, adolescence or adulthood, which are more common.

Types of freckles

However, freckles have a genetic origin. As a consequence, there will be people who will have freckles and others who will not, even if they have very similar skin and/or have spent the same amount of time exposed to the sun. With a DNA traits test, you can know your genetic predisposition and, thus, know if you have to take additional precautionary measures.

Studies have linked the presence of the melanocortin-1 receptor gene (MC1R) and its variants to the development of freckles. This gene has also been associated with an increased risk of developing skin cancer, as carriers of the MC1R gene have an increased sensitivity to the sun and show changes in skin pigmentation on a regular basis. Through a DNA test you can find out whether you have the mutation in this gene or not.

Freckles in redheads

Redheads have the MC1R gene mutation. Therefore, redheads are more likely to have freckles because they are more affected by solar radiation, since pheomelanin (chemical substance responsible for lighter hair colors) is photosensitive. For this reason, redheads are more prone to sunburn and should protect themselves with stronger sun protection factor (SPF) creams.

Freckles in redheads

For people who are more prone to freckles, i.e. redheads and people with lighter skin, it is important to check their freckles and moles regularly to detect any suspicious changes or irregularities early. This way, if melanoma (a very aggressive type of skin cancer) is developing, it can be detected early.

Melanoma and freckles

Melanoma can be well controlled if it is detected early and surgically removed. It is necessary to take into account what signs to observe to know if a freckle has to be treated:

  • Asymmetry. Freckles are usually rounded and symmetrical. If a freckle does not have this shape, it could be a first sign.
  • Border. It is important to notice if the border is irregular.
  • Color. If it changes color or there are two or more colors.
  • Diameter. If it is larger than 6 millimeters or grows in diameter.
  • Evolution. Freckles should be observed to see if they change in any aspect over time.

Despite not being a person prone to develop freckles or melanoma, it is important to take precautionary measures to avoid the appearance. Among the recommendations are:

  • Do not sunbathe during the hours of highest radiation, that is, avoid exposure to solar radiation between 12 and 16h.
  • Protect the most delicate parts of the body, such as the face, neck, chest and upper back with clothing or umbrellas.
  • Use approved sunglasses.
  • Apply sunscreen 30 minutes before sun exposure and every 2 hours. In addition, use it all year round and not only in summer.

It is important to know our body and our genes to know how we are and what can affect us the most. Despite taking precautionary measures with the skin, sometimes genetic predisposition favors the appearance of freckles. Observing freckles regularly and seeing a specialist if you detect any abnormality can help you to treat freckles in time.