Freckles And Age Spots
Both freckles and age stops are caused by pigmentation in the skin called melanin.
Melanin is produced by cells within the skin called melanocytes which are activated by exposure to ultraviolet (UV) light, and are the body’s natural process to attempt to protect us from harmful UV rays, like the rays of the sun.
People who have darker skin tones have more melanocytes, which result in a more uniform appearance, but in lighter-skinned people, melanocytes often respond to sun exposure with the appearance of freckles. There is a high chance that if one or both of a person’s parents have freckles, have fair skin or red hair, they might be genetically predisposed to having freckles too, even if they generally stay out of the sun.
While freckles usually present in clusters across larger areas of the skin, for example, across the bridge of the nose and forehead, age spots (which are also called sunspots, liver spots or solar lentigines) tend to present as a single spot, or in close proximity to 1-2 others.
Depending on how many melanocytes are clustered together, and how much melanin those clusters produce, coloration of freckles and age spots can be darker.
For almost all skin types, UV exposure will cause concentrated areas of increased melanin production known as age spots. Age spots are especially common in people over 50, but they can occur in younger people as a result of sun exposure.
Age spots may look very similar to cancerous growths and are often a sign that a person has had a significant amount of UV exposure. For those reasons, people who have age spots should have them assessed by the GP, especially if they have a new mark appear, or if an existing mark changes in appearance.
On their own, true age spots are harmless, and they don’t usually cause any pain or discomfort, but the way they look, and the stigma around their name can affect self-esteem, so many people consider having them removed or lightened. It is essential that any treatment to remove age spots is performed by a medically trained professional, as there are many so-called treatments (either in-salon, over the counter or ‘DIY’) that falsely advertise results, and these can lead to serious complications, including chemical or laser burns.
Symptoms of Freckles and Age Spots
Freckles are extremely common and present as small brown spots.
Since age spots can look like cancerous growths, it is important to keep an eye on any changes, and the British Association of Dermatologists (and others) recommends a simple ABCDE approach to identifying skin cancers;
This mnemonic device can be helpful in reminding people what to look out for, while self-monitoring, and can be beneficial in helping the GP track any changes with the skin.
Freckles can affect people of any skin tone, but are commonly seen in people with fairer skin and light or red hair. Freckles are often more prominent in the summer months. Unlike freckles, which usually fade when sun exposure is avoided, age spots do not fade.
Most age spots are usually;
Age spots might be the same size as a freckle, or they might be just over a centimetre across. They might also be grouped together in a larger cluster that looks more noticeable.
Causes of Freckles and Age Spots
The primary cause of freckles and age spots is overexposure to ultraviolet (UV) light, either from the sun, or from harmful artificial tanning practices, such as sunbeds or sunlamps.
While adhering to sun awareness advice – for example, staying out of the sun (especially during midday hours) and applying a broad-spectrum sunscreen - is best practice for everyone, patients who have age spots should take all precautions to avoid harmful UV rays since they might be more at risk of skin cancer. Staying in the shade, wearing a wide-brimmed hat and UV-blocking sunglasses outdoors are all recommended.
Treatment of Freckles and Age Spots at Derma
Your appointment will begin with a skin check and medical history, followed by recommended treatment options.
Treatment for age spots depends on several factors, including the location they appear on your body, and the the size and degree of pigmentation of the age spot, but together with the dermatologist, you will discuss the latest and most effective treatments. The dermatologist will explain all potential side-effects, enabling you to select the best option for you.
It’s important to note that while the dermatologist can treat many age spots effectively, it depends on whether treatment is medically suitable for an individual – for example, depending on the location of the age spots, or underlying medical conditions, not all treatments would be suitable for all people. Most people can safely have age spots treated, but like any medical treatment, it is important to undergo a thorough consultation beforehand.
In some cases, it’s possible to use a prescription cream under the supervision of the dermatologist, but you might be able to have an age spot removed through freezing, which is known as cryotherapy. Most people don’t need to have any anaesthetic or a follow-up appointment for cryotherapy.
Depending on the treatment preferred, the dermatologist might advise further tests, and follow-up appointments may be required to manage your treatment.
Whether or not you choose to undergo any treatment, you may need to return at regular intervals so that your skin can be closely monitored for changes, since having age spots or non-cancerous growths is likely to increase susceptibility to skin cancers. If this is the case, and if you also have moles, it may be advisable to consider mole mapping.