Freckles are light tan or brown macules scattered on the face or nose of a light-skinned,red-haired patient.
Both solar lentigines and freckles are pigmented macules occurring in response to sun exposure. However, significant differences exist. For example, solar lentigines are larger in size but fewer in number compared to freckles. Solar lentigines increase whereas freckles decrease in prevalence with age. Freckles occur in fair-skinned and red-haired individuals whereas solar lentigines occur in all races.
The patient and/or parents should be educated on sun avoidance, sunscreens, and skin cancer. Otherwise, no treatment is needed.
If therapy is desired, light cryotherapy may be tried initially if lesions are limited. Various lasers have been shown effective including the Q-switched Alexandrite, Nd:YAG, ruby and the 510 nm dye laser.
Note the relative lack of freckles where the hair protects from the sun.
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