freckles

Freckles are the new beauty spots

Written by: Jonine Moller, M.Sc. in Sports Science

We all know the picture of the red-haired, freckle-faced little child in our bedtime stories.We tend to feel sympathetic towards freckled cartoon characters as glasses and/or braces were usually a part of the package deal. Google Darla Sherman, Velma Dinkley, or Eliza Thornberry for examples. Recently, fashion has redefined freckles to be a beauty must [1]. Merida, in the Disney movie Brave, helps to redefine the initial stereotype. Considering this, what can be done to make sure you win a few more of these small sunspots? Is more sun exposure all that's needed, or are some people just born with them and others not?

Freckles are tiny brown spots that occur on the skin due to the overproduction and uneven distribution of melanin [2, 3]. Melanin is the pigment that gives your skin, eyes, and hair their colour [3]. The primary purpose of melanin is to protect the skin against the sun's harmful ultraviolet (UV) radiation [3]. Therefore, with increased exposure to UV rays, more melanin is produced to increase the skin's sun protection.

Freckles may be either light brown or dark brown, and their size may range from 1 to 3 mm, perhaps even up to 5 mm in the Japanese population [4]. Sun exposure makes them more pronounced, which means that the colour of these spots may fade during winter [4]. On the other hand, the appearance of age spots can be very similar. This is because both freckles and ageing spots occur due to an over-production of melanin [2]. Ageing spots, however, develop after numerous years of chronic sun exposure without adequate protection [5]. They are thus primarily caused by the sun. On the other hand, freckles are more genetically determined and frequently disappear with age. They may, however, increase in number during adolescence [6].

Although freckles are commonly known to increase with exposure to the sun, "severe" types of freckles may be independent of sun exposure [7]. Severe freckling refers to dark spots that are abundant all over the body. This is opposed to them mainly occurring on the face and arms in more moderate cases. Although sun exposure increases freckling, the number of freckles is more than 90% genetically determined [6].

Freckles are not the result of a single gene but rather the interplay between numerous gene variations. The IRF4 gene is of the strongest predicting genes, but there are other DNA role-players as well [6, 7]. The genes involved in freckling are not necessarily role players in the skin's sensitivity to the sun, skin colour, or tanning abilities [7]. Freckles are, however, more common in light-skinned individuals that do not tan as easily and burn quicker [6, 7]. Red hair frequently goes along with the latter skin type [7].

Treatments do exist to make freckles less visible. Chemicals such as 70% trichloroacetic acid (TCA) and 80% phenol are effective when applied locally. These chemicals work as a peel. Scabs form after application, and freckles "come off" when the scabs fall off [8]. Other treatment options include different types of laser, radiofrequency, and light therapies [9, 10, 11]. Since freckles, in themselves, are entirely harmless, the purpose of their removal is purely cosmetic [8].

There is an association between freckles and light, sun-sensitive skin; light skin is also commonly associated with the risk of sun damage and skin cancer. Being prone to freckles might therefore mean you are at higher risk for skin cancer [12]. Subsequently, freckles are a common risk factor, amongst many others, in melanoma prediction models [13]. In consideration, moles and freckles are both risk factors for skin cancer.

The risk probably has a genetic origin. Neither freckles nor moles cause cancer, but both are genetically more likely to occur in skin that is sensitive to sun exposure [14]. The same genes responsible for fair skin tones and light hair, which are associated with freckling, are also associated with skin cancer risk. Probably the most important consideration when it comes to freckles: they need to be differentiated from moles.

The reason involves early identification of skin cancer. Moles do not withhold inherent cancer risk, but they are how cancer frequently manifests. Therefore, freckle-prone individuals should give more attention to the inspection of their skin. Any dark spots that can be felt (i.e., have depth or thickness) should be assumed to be a mole and not a freckle [15]. If a mole grows in size, changes colour has more than two colours or has uneven borders, a doctor should examine it thoroughly [16]. Wearing sunblock is also advised for fair and freckle-prone skin. This is not only for freckles prevention but also for protecting your skin against the potentially harmful UV rays.

Our skincare report can determine whether you are genetically prone to freckles.

Reference:

[1] Engle, G. (2015). Scientifically Special: Freckles Not Only Make You Unique, But Beautiful. Elite Daily Lifestyle. https://www.elitedaily.com/life/culture/freckles-scientifically-unique/988203

[2] Ji, J., Yang, X., Flavel, M., Shields, Z. P., Neoh, J., Bowen, M.-L., & Kitchen, B. (2020). Age-Deterring and Skin Care Function of a Polyphenol Rich Sugarcane Concentrate. Cosmetics, 7(2), 30. https://doi.org/10.3390/cosmetics7020030

[3] Pillaiyar, T., Namasivayam, V., Manickam, M., & Jung, S.-H. (2018). Inhibitors of Melanogenesis: An Updated Review. Journal of Medicinal Chemistry, 61(17), 7395–7418. https://doi.org/10.1021/acs.jmedchem.7b00967

[4] Yamaguchi, K., Watanabe, C., Kawaguchi, A., Sato, T., Naka, I., Shindo, M., Moromizato, K., Aoki, K., Ishida, H., & Kimura, R. (2012). Association of melanocortin 1 receptor gene (MC1R) polymorphisms with skin reflectance and freckles in Japanese. Journal of Human Genetics, 57(11), 700–708. https://doi.org/10.1038/jhg.2012.96

[5] Takahashi, Y., Fukushima, Y., Kondo, K., & Ichihashi, M. (2017). Facial skin photo-aging and development of hyperpigmented spots from children to middle-aged Japanese woman. Skin Research and Technology, 23(4), 613–618. https://doi.org/10.1111/srt.12380

[6] Kukla-Bartoszek, M., Pośpiech, E., Woźniak, A., Boroń, M., Karłowska-Pik, J., Teisseyre, P., Zubańska, M., Bronikowska, A., Grzybowski, T., Płoski, R., Spólnicka, M., & Branicki, W. (2019). DNA-based predictive models for the presence of freckles. Forensic Science International: Genetics, 42(June), 252–259. https://doi.org/10.1016/j.fsigen.2019.07.012

[7] Zaorska, K., Zawierucha, P., & Nowicki, M. (2019). Prediction of skin color, tanning and freckling from DNA in Polish population: linear regression, random forest and neural network approaches. Human Genetics, 138(6), 635–647. https://doi.org/10.1007/s00439-019-02012-w

[8] Mradula, P., & Sacchidanand, S. (2012). A split-face comparative study of 70% trichloroacetic acid and 80% phenol spot peel in the treatment of freckles. Journal of Cutaneous and Aesthetic Surgery, 5(4), 261. https://doi.org/10.4103/0974-2077.104914

[9] Nguyen Huu, S., Lam Van, C., Van, T. N., Manh, T. N., Thi Minh, P. P., Nguyen Hong, S., Dinh Huu, N., Tran Cam, V., Pham Cao, K., Tran Hau, K., Gandolfi, M., Satolli, F., Feliciani, C., Tirant, M., Vojvodic, A., & Lotti, T. (2019). Successful treatment of freckles by Alex trivantage laser wavelight 755 nm in Vietnamese patients. Open Access Macedonian Journal of Medical Sciences, 7(2), 287–290. https://doi.org/10.3889/oamjms.2019.096

[10] Singh, D. R. (2019). Efficacy and safety of radio frequency in acne and freckles. Journal of Medical Science And Clinical Research, 7(7), 362–368. https://doi.org/10.18535/jmscr/v7i7.67

[11] Xiao, Y. (2020). A clinical study on treatment of facial freckles with intense pulsed light. E3S Web of Conferences, 145, 9–11. https://doi.org/10.1051/e3sconf/202014501003

[12] Kvaskoff, M., Mesrine, S., Clavel-Chapelon, F., & Boutron-Ruault, M. C. (2009). Endometriosis risk in relation to naevi, freckles and skin sensitivity to sun exposure: The French E3N cohort. International Journal of Epidemiology, 38(4), 1143–1153. https://doi.org/10.1093/ije/dyp175

[13] Kaiser, I., Pfahlberg, A. B., Uter, W., Heppt, M. V., Veierød, M. B., & Gefeller, O. (2020). Risk prediction models for melanoma: A systematic review on the heterogeneity in model development and validation. International Journal of Environmental Research and Public Health, 17(21), 1–25. https://doi.org/10.3390/ijerph17217919

[14] Baron, A. E., Asdigian, N. L., Gonzalez, V., Aalborg, J., Terzian, T., Stiegmann, R. A., Torchia, E. C., Berwick, M., Dellavalle, R. P., Morelli, J. G., Mokrohisky, S. T., Crane, L. A., & Box, N. F. (2014). Interactions between ultraviolet light and MC1R and OCA2 variants are determinants of childhood nevus and freckle phenotypes. Cancer Epidemiology Biomarkers and Prevention, 23(12), 2829–2839. https://doi.org/10.1158/1055-9965.EPI-14-0633

[15] Mohr, P., Eggermont, A. M. M., Hauschild, A., & Buzaid, A. (2009). Staging of cutaneous melanoma. Annals of Oncology, 20(SUPPL. 4), vi14–vi21. https://doi.org/10.1093/annonc/mdp256

[16] Moles. (n.d.). NHS. Retrieved August 2, 2021, from https://www.nhs.uk/conditions/moles/

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