eMedicine Specialties > Dermatology > Photo-Related Diseases

Ephelides (Freckles): Treatment & Medication

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

Treatment

Medical Care

Treatment is not necessary for ephelides (freckles).

  • If a patient wishes to alter the cosmetic appearance, then sun avoidance and makeup can be used.
  • Sunscreens may be used to prevent enhancement of the freckling caused by sun exposure.
  • If desired, chemical peelscryotherapy, and laser treatment have all been attempted to make ephelides less pronounced. In one study of 48 patients, 71% had at least 50% improvement in pigmentation with an intense pulsed light source.11  
  • Another study compared Q-switched alexandrite laser and intense pulsed light for the treatment of freckles and lentigines in Asian patients. The Q-switched alexandrite laser was found to be superior to intense pulsed light for freckle treatment.12

More on Ephelides (Freckles)

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

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].

Further Reading

Keywords

ephelides, freckles, xeroderma pigmentosum

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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