Freckles are small flat brown dots arising on the face and other sun exposed areas. They are most often seen in fair skinned people, especially those with red hair. The brown colour is due to increased melanin pigment production and localized, concentrated accumulation in the skin cells. Melanocytes are stimulated to make more melanin when exposed to the sun. Therefore freckles are prominent in the summer months, but fade considerably or disappear in the winter. Apart from sun protection, no particular treatment is necessary.
“Age spots” or “liver spots” are medically termed solar lentigines (a single spot is called a solar lengtigo). These are larger flat brown spots found commonly on the face and hands in middle age adults. Unlike freckles they tend to persist for long periods and don’t disappear in the winter. Solar lentigines are common seen in those with fair skin, but may also occur in those who tan easily and have had a lot of sun exposure in the past. Lentigines are due to localised proliferation of melanocytes.
Brown marks may fade with regular use of broad-spectrum, high SPF sunscreens and sun protection. Fading creams which contain hydroquinone, kojic acid, arbutin, alpha-hydroxy acids, vitamin C, retinoids, or azelaic acid can also be used. Procedures such as chemical peels, microdermabrasion, cryotherapy, or lasers that target melanin pigment in the skin would work more effectively than topical creams.
Should I be concerned about my brown spots?
If your brown spot looks asymmetrical, has irregular borders, multiple colors, large in diameter and/or the appearance has evolved/changed (ABCDEs of malignant change) you should see your doctor for advice.
