Should I Be Worried About My Freckles?

by Dr Wan Chee Kwang
January 20, 2021

Some love their freckles, and I’m sure they're not alone. They’re a reminder of happy, carefree days spent frolicking under the sun and the games played with the kids on court. But with that said, any type of pigmentation on our skin formed as a result of sun exposure can be damaging, and freckles are not excluded. 

Did you know that in Singapore, skin cancer falls under the top ten most frequent cancers? According to the Singapore Cancer Registry, the prevalence of skin cancer has been rising in numbers in both men and women across all ages. I won’t say that is surprising news, keeping into consideration Singapore’s tropical climate. Unless you’re indoors all year, it’s almost impossible to avoid contact with the sun. And because we’re a susceptible population, it’s all the more important to keep a lookout for warning signs and load up on protection.

Recognising freckles

I’ve written in previous articles the ABCDEs of moles, or ways to do a self-examination on your moles. The same protocol can be applied for freckles except it’s a lot harder since freckles usually present in a cluster and are a lot smaller. Like glowing, radiant tans, freckles may look healthy but are actually a sign of excessive sun exposure or an overproduction of melanin. Certain genetics also put you at a higher risk of freckles. 

There are two types of 'freckles': ephelides and solar lentigines. 

Ephelide freckles form as a result of excessive sun exposure. They appear on parts of your body frequently exposed to the sun and tend to be more common in people with lighter skin tone and hair colour. 

Solar lentigines develop over the course of adulthood and include freckles, sun spots and age spots. There are several factors that increase the likelihood of developing solar lentigines, including: 

  • Dark skin 
  • The ability to get a tan 
  • Existing freckles on the body 
  • Sun exposure 
  • Hormone treatment such as birth control pills 

So essentially, freckles fall into both categories but they don’t necessarily mean danger unlike moles or sun spots. This is because under a microscope, freckles contain a normal number of pigment-producing cells. They also tend to fade with age. Sun spots, on the other hand, have a higher number of pigment-producing cells. In addition, they develop later in life and do not fade. 

Because freckles and sun spots look pretty identical, here’s some ways to tell them apart:

EphelidesSolar lentigines
(including sun spots)
How they formSun exposure and geneticsSun exposure
When they appear2-3 years after sun exposure and
fade over time
Accumulate with age and tend to
appear after 40
Where they appearFace, neck, arms and chestFace, forearms, hands, back, chest,
shins and anywhere on sun-exposed skin
Ability to changeAppear mostly if you’re always under the sun,
fade when you’re away from the sun for
a prolonged period
Present all the time
SizeAbout 1 to 2mm but can be larger2mm or larger
BorderIrregular or well definedMostly well defined
ColourRed to light brownPale yellow to dark brown
Freckles on women's skin

Keep an eye out for your freckles

The good news is that for the most part, freckles are harmless — at least compared to other spots on your skin. But freckles are still markers of UV-induced damage and sun exposure which put you at risk of skin cancer down the road, so I wouldn’t call it victory too soon and would continue to monitor them. Studies show that individuals with a higher density of freckles are at a greater risk of developing skin cancer later in life. How I observe freckles is by colour —  if your freckles are getting darker, then it’s a sign that you’re getting too much sun exposure and should probably load up on the sunscreen. If you’re one of those who are prone to freckles, don’t get too worried — just make sure you see a dermatologist regularly and keep an eye out for changes to your freckles.

Take the necessary precautions

Even if your freckles don’t signal any bad news after observing them, always take proper precautions as prevention is key. I recommend applying a mineral-based sunscreen of at least SPF 30 everyday even if you won’t be out in the sun for long, and if you are, consider wearing a wide-brimmed hat and shades to shield your face away from the sun. If possible, consume a diet rich in antioxidants and anti-inflammatories like fruits, vegetables, proteins and healthy fat. 

If all that sounds like too much, then at least just apply sunscreen daily. That is a must. For some reason luckily, I’m noticing more younger people realising the importance of sunscreen now, so that is good news. Keep up this habit and it will pay off; protecting your skin is a lifelong effort!


  1. Handel, A. C., Miot, L. D., & Miot, H. A. (2014). Melasma: a clinical and epidemiological review. Anais brasileiros de dermatologia89(5), 771–782.
  2. Watson, M., Holman, D. M., & Maguire-Eisen, M. (2016). Ultraviolet Radiation Exposure and Its Impact on Skin Cancer Risk. Seminars in oncology nursing32(3), 241–254.

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