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Freckles - Scientific answer to all your questions

Freckles are light brown spots usually seen in the face of fair-skinned people. In this question asnwer session, we provide you answer to your most common questions related to freckles.

Author : , MD(School of tropical medicine, India),Dermatologist
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freckles
Cause of freckles

What causes freckles on the face?

Freckle is mainly formed by exposure to Sunlight more specifically UVB components of it (Apart from visible light, sun-light has different types of ultraviolet lights like UVA , UVB etc)

Why am I getting more freckles as I get older?

Solar lentigines and freckles are 2 related almost similar looking conditions. Where lentigines might be more common as people grow older, there is usually no correlation for freckles.
Reference : 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. 2004;17(3):225-229. doi:10.1111/j.1600-0749.2004.00131.x

Are freckles genetic?

Yes many times freckles are genetic and run in families. Also sometimes freckle is part of different syndromes which are usually genetic as well. However it does not mean that there is no way to prevent it. Just the chance of getting it increases if it’s there in the family.

About prevention

How do I stop getting freckles? How do I stop my child getting freckles?

You may take the following steps.

  1. use of sunscreens with SPF (sun protection factor) of at least 30. Sunscreen needs to be applied liberally and 15-20 minutes before sun exposure.
    Here is a guide to choose the perfect sunscreen for you.
    Here is how you should apply sunscreen.
  2. use of sun-protective clothing (shirts, long sleeves, long pants),
  3. Limit sun-exposure of the peak sun hours of 10 a.m. to 4 p.m.
  4. Seek shade and stay indoor as much as possible.


Treatment expectation

How do I permanently remove freckles from my face?

Yes. With procedural treatment like radio-frequency , chemical peel or laser, individual freckle spots can be removed permanently. But unfortunately they tend to come back. So taking preventive steps ( as outlined above ) is very important.

How long does it take for freckles to fade? How can it be faster ?

Certain treatments like topical cream take time to act. Chemical peels usually burn (limited burn , nothing to worry ! ) the area and the black spot might remain for a few weeks. Lasers or electrocautery usually remove it instantly.

Home remedies

Are there any effective home remedies for freckles ?

Some home remedies can lighten the appearance for sure but if you were following all those popular blogs and Youtube channels that claim to have the perfect home remedies for freckles, we have some bad news. Contrary to what you might want to hear, no aloe vera, organic oil or apple cider will remove your freckles. Certain fruit juices like lemon juice however might make it lighter and a good option for maintenance. 

How does lemon juice / vitamin C get rid of freckles?

Basically lemon juice contains organic acids (citric acid, ascorbic acid or vitamin C etc) that helps to exfoliate the outer layer of your skin and gives it a lighter appearance. Take one teaspoon of lemon juice and gently massage it over your freckles using your fingertips. Leave it for 5-10 minutes. Keep doing this for a few weeks. If it does not improve, do not forget to consult a dermatologist. The chance is very rare that you would get rid of freckles by this method alone.

Role of diet

What to eat to reduce freckles?

Contrary to what you might find in many popular blogs and videos, diet has no proven scientific association with freckles. In general a balanced diet might help to protect your skin from various internal damage but there is no specific relevance for freckles.

Which vitamin is good for freckles?

When topically applied, Vitamin C ( citric acid) has a skin-rejuvenating effect and also can fade freckles. Actually any fruit juice might do it because of the presence of natural acid. This principle is used in case of treatment with chemical peels where such acids are used in much higher concentration than natural sources. Vitamin pills or vitamin presence in food does not help to prevent freckles.

Getting the right treatment

What is the best cream to get rid of freckles?

Your dermatologist might prescribe you an exfoliating cream like glycolic acid cream or retinoid cream. Please note that do not apply retinoid cream should not be taken during pregnancy. Also the efficacy of creams are limited so dermatologists usually prefer certain procedures to remove it.

How do dermatologists remove freckles?

Freckles can be removed by a number of procedures, the common principle among them is to destroy the black melanin particles in a targeted manner so that surrounding areas bear minimal damage. Most popular procedures are laser treatments, electrocautery and chemical peels.

How much does freckle removal cost?

In India, you might expect the cost of such a procedure to range from few hundred to few thousands depending on location and demands. Charges are usually higher in metro cities like Mumbai and Delhi.

Does freckle removal hurt?

Usually before doing the procedure, the dermatologist or his/her clinic stuff will use some gel to numb the area. If there is still burning sensation , an ice-pack applied over the area will help.

What laser removes freckles?

Freckles can be removed by IPL (intense pulse light) and a variety of lasers such as alexandrite , ruby or q-switched laser. As freckles is a benign condition and pigment is very superficial, high-end powerful lasers are not required.
Here is a video to watch to understand the procedure (We do not have any association with the clinic posted the video)

Does IPL get rid of freckles?

Though technically not a laser, IPL is one of the most effective ways to treat freckles

How many laser/IPL sessions does it take to remove freckles?

Often freckles are removed effectively in the first session only as the pigmentation is not at all deep. If removal is incomplete or the number of freckles is very high, a second session might be planned after a few weeks.

How long does it take for freckles to fade after IPL or laser treatment?

Though with lasers, the melanin pigments are instantly destroyed, the debris might remain there upto few weeks. Sometime immediately after the procedure it seems darker due to damage to surrounding areas. If the procedure is done correctly, the spots should however fade within a few weeks.

Will freckles come back after IPL?

Yes ! No freckle removal procedure is permanent and your chance of getting freckles in the future does not change with treatment of current spots. So after the removal, you should follow the steps or prevention as outlined above (see prevention section).

Is chemical peel good for freckles?

Chemical peels are an effective and safe treatment for freckles when it is done with proper protocol. As it is applied only over the spots and not on the whole face (like in many other conditions), it is often referred to as spot or touch treatment. Like we call it 88% phenol touch, rather than phenol peel.

Which chemical peel (touch) is best for freckles?

Usually medium or deep peels are used in very small amounts such as TCA (tri-chloro-acetic acid) or phenol peels are used. 

Does glycolic acid remove freckles?

Being a very superficial peeling agent, glycolic acid is good for maintenance and gives the surrounding skin a glow. But when it comes to removing the freckle, it is not as effective as TCA or phenol touch.

How much does chemical peel / touch treatment for freckles cost?

As the amount needed for treatment is much less compared to other procedures, often it is lower than the IPL or Laser treatment. However in metro cities, it may go up to a few thousand bucks (INR)

Special situation

Is it normal to get freckles during pregnancy? Will it go away after pregnancy ?

Hormonal changes during pregnancy makes existing darker areas even darker and freckles are no exception. But as you might guess, this additional darkening usually will go away after delivery.

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Other problems related to black spots (pigmentation)

Unwanted black spots over face or any parts of our body are common skin problems. While sometime it can be due to a simple post acne spot, sometime may indicate a more complicated diseases like acanthosis nigricans.

Preventing black spots

Choosing sunscreen - essentials things to know.

Specific skin problems

Melasma - Comparison of all treatment options

Acanthosis nigricans - your black neck can be a sign of Diabetes.

Dark circle - Different types and their treatment

Not sure about your problem ?

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