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Freckles are harmless tan, brown or black flat spots that appear on areas of the skin that have been
exposed to the sun. Freckles are more common in those with lighter skin, red or blond hair, and in
those who sunburn easily. Unlike age spots, freckles are common in childhood and fade in the winter.
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Freckles are commonly found on the face and hands, and any other part of the body that has been
overexposed to the sun. Freckles are among the many signs of photoaging which occurs when
excessive sun exposure speeds the skin's natural aging process.
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Freckles have no associated symptoms however, if you notice that your freckles are changing or
getting larger, they may need further evaluation by your physician. Also, if you have freckles,
you have a higher risk of skin cancer than a person who doesn’t.
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Your physician can usually distinguish freckles from other types of lesions based upon their
appearance on your skin.
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The best treatment for freckles is prevention and the key to preventing freckles is sun avoidance
and daily sunscreen use. However, for most of us, it is too late for prevention so there are a
number of treatment options available.
Bleaching Creams
- What they are:
There are many over the counter and prescription medications that may be used to treat
freckles. One popular over-the-counter medication contains 2 percent hydroquinone which is a
bleaching agent. Prescription creams may use single agents, such as Retin-A (tretinoin) or
combinations of medications such as hydroquinone with tretinoin plus a cortisone cream.
- What are the risks?
Over the counter bleaching creams are usually well tolerated and may gradually lighten
freckles over a couple of months however, they are not very effective and sometimes bleaching
agents can lighten the skin around the freckle. Prescription formulations are often more
effective but may have more side effects (such as redness, drying, and peeling) and are
expensive. Your physician may treat your freckles with liquid nitrogen freezing.
Topical treatments and creams may not work for everyone and the risks and benefits need to be
discussed with your physician.
Chemical Peels
- What are they?
Your physician can administer a peel using a variety of different chemicals to remove age
spots, freckles, discoloration, wrinkles and fine lines. Chemical peels may smooth and firm the
skin while gradually lightening freckles. The superficial peels such as a glycolic acid peel
can be performed during your lunch hour and there is no recovery time while deeper peels are
more effective but require longer recovery. See more details under discussion chemical peels.
- What are the risks?
Different kinds of peels carry different risks. Superficial peels are usually quite safe
however, you may need a series of superficial peels (done approximately once a month)
before you'll notice improvement plus the costs can add up if you choose a series of peels.
The risks and benefits vary depending on the kind of peel and need to be discussed in detail
with your physician.
Laser Resurfacing
- What are they?
An in-office treatment where freckles, melasma, age spots wrinkles and fine lines are "burned"
off with a laser. Laser resurfacing can effectively treat these conditions in just one treatment.
- What are the risks?
Because lasers remove the outer portion of the skin (the epidermis) you may experience some
pain, redness, and peeling. Scabs, as well as some scarring (in rare cases) sometimes form days
after the procedure. Expect recovery time of at least a week. Laser therapy is also expensive as
one treatment can cost, depending on how much of your face is treated, anywhere from $1,000 to
$5,000. On the other hand, the CO2 laser is the most effective way to rejuvenate your skin and
with good sun protection, the effects can last up to five years. The risks and benefits of laser
resurfacing need to be discussed in detail with your physician.
Intense Pulsed Light Therapy (IPL)
- What are they?
IPL is one of the newer forms of facial rejuvenation. Unlike lasers, which use intense,
focused light, IPL is intense broadband light. Although IPL delivers energy to both the
superficial (epidermis) and deep (dermis) layers of the skin, the epidermis is spared from
any damage so there is virtually no recovery time. In the most recent studies, IPL can improve
the texture of the skin and fade freckles, age spots, melasma, and even visible blood vessels
and with good sun protection, benefits usually last for about a year.
- What are the risks?
Because IPL does not damage the epidermis, it is safer than laser therapy. There may be some
pain during the procedure but no recovery time. Unlike laser therapy, however, multiple
treatments (4-6, at three weeks intervals) are often needed to achieve the full benefit.
The cost is variable, but is usually more expensive than peels and less expensive than lasers.
As with any surgical procedure, the risks and benefits of IPL therapy need to be discussed in
detail with your physician.
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