Conditions · Pigment

Freckles

Ephelides are a genetically determined sun response — melanin production without an increase in melanocyte number. They darken with exposure and fade without it.

Mechanism

What is actually happening

Existing melanocytes produce more pigment in response to ultraviolet light. The cell count is normal, which is why freckles behave differently from lentigines and why they recur with exposure.

The distinction

How it is told apart

Freckles fade in winter and return in summer. Solar lentigines do not fade. That single observation separates them, and it changes what treatment can realistically promise.

Assessment

What is established first

Distribution, whether the pattern is longstanding since childhood, seasonal variation, Fitzpatrick type and family history.

Approach

What is typically done

Pigment-selective treatment reduces visible pigment, but because the underlying response is genetic, recurrence with sun exposure is expected rather than a failure. Photoprotection is the durable part.

When treatment waits

When it is deferred

Anyone seeking permanent removal is told plainly that the response is genetic and returns with exposure.

Frequently asked

What is freckles?

Ephelides are a genetically determined sun response — melanin production without an increase in melanocyte number. They darken with exposure and fade without it.

How is freckles told apart from similar conditions?

Freckles fade in winter and return in summer. Solar lentigines do not fade. That single observation separates them, and it changes what treatment can realistically promise.

What is assessed before treating freckles?

Distribution, whether the pattern is longstanding since childhood, seasonal variation, Fitzpatrick type and family history.

When is treatment deferred?

Anyone seeking permanent removal is told plainly that the response is genetic and returns with exposure.

Have this assessed

Every assessment is carried out personally by Dr Sin Yong, Medical Director. 9 Scotts Road, #12-01 Pacific Plaza.

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