Are Sunspots the Same as Freckles?

What are sunspots? Why do they appear dark, and how are they different from freckles?

You all know that I'm all about education...and focused on informing you on the best teen skincare and tween skincare options. My hope is to prevent the large majority of skin cancers and skin damage by getting all of you teens and tweens into consistent daily skincare habits.

Sunspots and freckles are one of the most visible measures of sun damage that our skin has accumulated. In this article, I hope to inform you about the differences between freckles and sunspots, understand how the right teen skincare regimen can keep your skin healthy and prevent damage to your skin (with the best sunscreens for teens and tweens), and options for treating sunspots and sun damage if this has already occurred.

First, let's start with terminology

Freckle=ephilis (plural is ephelides)

Sunspot=lentigo (plural is lengines)

Although both appear as brown spots on your skin, sunspots, also known as liver spots or solar lentigines, are distinct from freckles. Freckles, also known as ephelides, typically fade during times of minimal sun exposure (such as the winter months) while a lentigo persists year round. Sunspots are usually seen in adults (in my practice, ages 35 and older), while freckles can appear in early childhood and throughout our lifetimes. An individual will often have both ephelides and lentigines on their skin, both resulting from acute, chronic and cumulative sun exposure over time. Freckles are smaller (less than a couple of mm in size) and will often occur after direct and concentrated UV exposure; for example, after a beach vacation or tanning bed use.

There is a genetic component to freckles, often involving the MC1R gene, that is commonly expressed in individuals with light skin. Sunspots, or lentigines, are usually larger than 3mm, pigmented macules and tend to remain on the skin, even in the absence of recent sun or UV exposure. Sunspots may have a slightly scaly surface.

In both freckles and sunspots, UV exposure stimulates the melanocytes, which are the pigment-producing cells in our skin, to produce more melanin. The melanin is transferred into the keratinocytes, aka skin cells, and this produces a darkening of the skin. Clinically, this looks like a tan or like freckles/sunspots. Microscopically, sunspots may have an increased number of pigment-producing melanocytes compared to normal skin.

What are the risks associated with sunspots

Although sunspots/lentigines in and of themselves are benign, they are a marker of cumulative sun damage that has occurred over time. Sunspots are not precancerous or cancerous, but given their direct correlation with sun exposure over time, they can arise in areas of the skin that are more prone to precancers and skin cancer due to accumulated sun damage. Given their benign nature, however, sunspots are not harmful but can be cosmetically bothersome.

How to prevent sunspots

Daily application of broad-spectrum sunscreen, SPF 30 or higher, UVA/UVB protection, is first-line in prevention of sunspots. Applying sunscreen in adequate amounts (approximately 1/2 teaspoon for face and neck, a full 1 oz shot glass for full body) is important to provide adequate protection. Sunscreen should be reapplied every 2 hours when outdoors as sun exposure can break down the active sunscreen ingredients and sweat/water can wash sunscreen off of the surface of the skin. The best sunscreen for you is the one that works with your skin and that you are going to be consistent in applying each day. Sun protective measures such as avoidance of sun during peak hours (10am-3pm), wide-brimmed hats and sun-protective clothing are very helpful.

For best results, use a mineral sunscreen, such as the Bright+Block sunscreens. Why are these the best sunscreens for teen skin? They are broad spectrum (protect against UVA and UVB rays from the sun), hydrating, and sheer. We love how our Bright+Blocks glide effortless over the skin and never pill or clump.

Consistently ranked among the best facial sunscreens for teens, our Bright+Blocks work beautifully on their own or under makeup. Plus, our tinted Bright+Block SPF 44 has iron oxide pigments that protect against blue light.

How to get rid of sunspots

Topical: Topical creams/lotions will have a modest effect on improving sunspots. These can work by a variety of mechanisms. Alpha-hydroxy acids and retinoids/retinols exfoliate the skin and superficial portion of the sunspot, allowing fresher skin to come to the surface. Azelaic acid, hydroquinone, and kojic acid inhibit tyrosinase, the enzyme that plays an important role in melanin production. Niacinamide (vitamin B3) actually blocks the transfer of melanin pigment from the melanocytes (pigment-producing cells) to the keratinocytes (other cells within the skin.) 

Laser: Lasers, such as the Q-switched Nd:Yag laser, Q-switched ruby laser, Q-switched Alexandrite laser, or the KTP laser are very effective in treating sunspots as these devices target melanin, the pigment that renders a brown/dark appearance to the sunspot. Picoseond lasers also work well. Multiple treatments are typically required with lasers to significantly reduce the sunspots. Because lasers are very specific in targeting the pigment (and bypassing other skin structures), they tend to be safe and run minimal risk of scarring. Lasers can cause hyper or hypopigmentation, and patients should be counseled accordingly.

Light Devices: Intense Pulsed Light (IPL) is less specific in targeting melanin compared to lasers but also addresses discoloration and sun damage in a more general way. Similar to lasers, IPL can cause hyper- or hypopigmentation.

Cryotherapy: Liquid nitrogen can be carefully applied to the sunspot, destroying the surface skin cells that contain the pigmentation. This should be performed only by a trained provider as cryotherapy runs a risk of hyper- or hypopigmentation.

Chemical peels: By selectively destroying the superficial, pigment-containing skin cells, exfoliating, and allowing new skin cells to generate, chemical peels can reduce the appearance of sunspots.

Conclusion

I hope that this information is helpful as you understand the WHY behind teen sunscreens, tween sunscreens, and preventing sun damage. Remember, consistent habits, including daily application of sunscreen, will help you realize your healthiest skin!

Smart Skin starts Now,

Dr. Angela