How is it Diagnosed?
Freckles are small, flat, tan or light-brown spots on the skin, commonly found on sunexposed areas such as the face, shoulders, and arms. They are medically termed
ephelides and are typically harmless. Diagnosis of freckles is largely clinical, based on
visual inspection during a dermatological examination.
A detailed history is obtained to assess risk factors, including sun exposure, family
history, and skin type. Freckles are more common in individuals with lighter skin tones,
especially those with red or blonde hair and blue eyes. They tend to become darker in
summer and fade during winter, which can help differentiate them from other
pigmented lesions.
Dermatologists may use a dermatoscope, a handheld magnifying tool with a light
source, to examine the pigmentation pattern more closely. Freckles appear as uniform,
flat spots with no changes in texture or border irregularities.
Differentiating freckles from other skin conditions such as lentigines, solar keratoses, or
melanomas is crucial. Lentigines are darker and do not fade with seasonal changes,
while suspicious lesions may warrant a skin biopsy to rule out malignancy, especially if a
spot changes in size, shape, or color.
In summary, the diagnosis of freckles is straightforward, primarily involving visual
assessment and patient history. When necessary, dermatoscopic evaluation or biopsy
may be used to confirm the benign nature of the pigmentation and to exclude serious
dermatological conditions.