eMedicine Specialties > Dermatology > Photo-Related Diseases

Ephelides (Freckles): Follow-up

Author: Jessica M Scruggs, MD, Resident Physician, Department of Dermatology, Scott and White Memorial Hospital, Texas A&M Health Science Center College of Medicine
Coauthor(s): Katherine H Fiala, MD, Assistant Professor, Department of Dermatology, Scott and White Northside Clinic
Contributor Information and Disclosures

Updated: Nov 13, 2009

Follow-up

Complications

  • Ephelides (freckles) may be cosmetically unappealing, but they are not associated with any complications. However, studies have shown that individuals with skin types susceptible to ephelides are at greater risk for developing both melanoma and nonmelanoma skin cancer.13 This association is likely because ephelides 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.

Prognosis

  • The prognosis for ephelides is excellent.

Patient Education

  • Patients should be reassured that ephelides are benign.
    • Despite the benign nature of ephelides, patients should always be educated on the harmful effects of the sun.
    • Patients should be informed to use sunscreens that protect against UV-A and UV-B radiation and to avoid sun exposure, especially between peak hours (10:00 am to 4:00 pm).
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors, Lorne Hurst, MD, and Shane G. Silver, MD, and previous Chief Editor, William D. James, MD, to the development and writing of this article.



More on Ephelides (Freckles)

Overview: Ephelides (Freckles)
Differential Diagnoses & Workup: Ephelides (Freckles)
Treatment & Medication: Ephelides (Freckles)
Follow-up: Ephelides (Freckles)
Multimedia: Ephelides (Freckles)
References
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References

  1. Azizi E, Lusky A, Kushelevsky AP, Schewach-Millet M. Skin type, hair color, and freckles are predictors of decreased minimal erythema ultraviolet radiation dose. J Am Acad Dermatol. Jul 1988;19(1 Pt 1):32-8. [Medline].

  2. Bastiaens M, Hoefnagel J, Westendorp R, Vermeer BJ, Bouwes Bavinck JN. Solar lentigines are strongly related to sun exposure in contrast to ephelides. Pigment Cell Res. Jun 2004;17(3):225-9. [Medline].

  3. Cockerell CJ, Johnson TM, Swanson NA. Melanocytic nevi. J Cutan Med Surg. 1996;2:1561-3.

  4. Hurwitz S. Clinical Pediatric Dermatology. 2nd ed. Philadelphia, Pa: WB Saunders; 1993:211-2.

  5. Rhodes AR, Albert LS, Barnhill RL, Weinstock MA. Sun-induced freckles in children and young adults. A correlation of clinical and histopathologic features. Cancer. Apr 1 1991;67(7):1990-2001. [Medline].

  6. Yang S, Xu SX, Xiao FL, et al. Prevalence and familial risk of ephelides in Han Chinese adolescents. Arch Dermatol Res. Feb 2008;300(2):87-90. [Medline].

  7. Bastiaens M, ter Huurne J, Gruis N, Bergman W, Westendorp R, Vermeer BJ. The melanocortin-1-receptor gene is the major freckle gene. Hum Mol Genet. Aug 1 2001;10(16):1701-8. [Medline].

  8. Hölzle E. Pigmented lesions as a sign of photodamage. Br J Dermatol. Sep 1992;127 Suppl 41:48-50. [Medline].

  9. McLean DI, Gallagher RP. "Sunburn" freckles, café-au-lait macules, and other pigmented lesions of schoolchildren: the Vancouver Mole Study. J Am Acad Dermatol. Apr 1995;32(4):565-70. [Medline].

  10. Crowe FW. Axillary freckling as a diagnostic aid in neurofibromatosis. Ann Intern Med. Dec 1964;61:1142-3. [Medline].

  11. Kawada A, Shiraishi H, Asai M, et al. Clinical improvement of solar lentigines and ephelides with an intense pulsed light source. Dermatol Surg. Jun 2002;28(6):504-8. [Medline].

  12. Wang CC, Sue YM, Yang CH, Chen CK. A comparison of Q-switched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian persons: a randomized, physician-blinded, split-face comparative trial. J Am Acad Dermatol. May 2006;54(5):804-10. [Medline].

  13. Bliss JM, Ford D, Swerdlow AJ, et al. Risk of cutaneous melanoma associated with pigmentation characteristics and freckling: systematic overview of 10 case-control studies. The International Melanoma Analysis Group (IMAGE). Int J Cancer. Aug 9 1995;62(4):367-76. [Medline].

  14. Lorincz Al. Disturbances of melanin pigmentation: circumscribed melanoses. Dermatology. 1985;2:1273-7.

  15. Nicholls EM. Genetic susceptibility and somatic mutation in the production of freckles, birthmarks and moles. Lancet. Jan 13 1968;1(7533):71-3. [Medline].

  16. Pavlotsky F, Azizi E, Gurvich R, et al. Prevalence of melanocytic nevi and freckles in young Israeli males. Correlation with melanoma incidence in Jewish migrants: demographic and host factors. Am J Epidemiol. Jul 1 1997;146(1):78-86. [Medline].

  17. Wilson PD, Kligman AM. Do freckles protect the skin from actinic damage?. Br J Dermatol. Jan 1982;106(1):27-32. [Medline].

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Further Reading

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Keywords

ephelides, freckles, xeroderma pigmentosum

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Contributor Information and Disclosures

Author

Jessica M Scruggs, MD, Resident Physician, Department of Dermatology, Scott and White Memorial Hospital, Texas A&M Health Science Center College of Medicine
Jessica M Scruggs, MD is a member of the following medical societies: American Medical Association, American Medical Student Association/Foundation, American Medical Women's Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Katherine H Fiala, MD, Assistant Professor, Department of Dermatology, Scott and White Northside Clinic
Katherine H Fiala, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Medical Editor

Sungnack Lee, MD, Vice President of Medical Affairs, Professor, Department of Dermatology, Ajou University School of Medicine, Korea
Sungnack Lee, MD is a member of the following medical societies: American Dermatological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Christen M Mowad, MD, Associate Professor, Department of Dermatology, Geisinger Medical Center
Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Catherine M Quirk, MD, Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania
Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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