Freckles (Ephelides) are a very common anomaly. They either discrete, grouped or confluent pigmented macules caused by excessive, localized formation of melanin; the size of a freckle, however, varies. It can be anywhere between the size of a pin-head and a split pea (sometimes larger). Freckles occur symmetrically on the exposed parts of the body like the face, neck and forearms; if other parts of the body are exposed, as for instance in sunbathing or when sleeveless cloths are worn, they may also be affected. White people, blondes, red-heads and people with delicate, fair skins are prone to freckles. Hence dark-skinned people like Indians and Africans rarely develop freckles.
Freckles are tanned macules found on the skin. They are usually multiple in number. With sun exposure, they become more apparent; therefore, in the winter months, they are often imperceptible. Although freckles are predominantly benign, they may be seen in association with systemic disease.
Freckles considered cute by some, they are a real problem for others. Freckles, also known as, ephelides, are small brown or tan patches common in individuals with lighter skin, blond or red hair. They appear early in life, increase in number during summer months and fade in winter.
Individuals who are genetically susceptible may have somatic mutations in epidermal melanocytes that promote increased melanogenesis. Melanocytes are not increased in number, and they may even be decreased in number. With UV-A and UV-B exposure, the dopa reaction is increased, leading to the production of larger melanosomes, which produce the clinical picture.
Freckles may be cosmetically unappealing, but they are not associated with any complications. However, recent studies have shown that individuals with skin types susceptible to freckles are at greater risk for developing skin cancers. This association is simply because freckles and skin cancers are more common in people who are regularly exposed to the sun and have skin types I and II than in other people.
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