Freckles, also known as ephelides, are small pigmented spots ranging in size from 1 to 5 mm, though they may merge to form larger patches.
They appear on sun-exposed areas and typically develop during childhood and adolescence. Mucous membranes are never affected. Light phototypes are the most commonly affected, especially redheads.
These pigmentations are relatively pale — light brown or ochre — and darken with sun exposure, returning to their original color afterward.
Freckles are not a health concern and do not evolve into melanoma.
Freckles are small skin spots that appear in childhood. Their quantity varies : some people have a few on the nose and cheeks, while others are covered in them. These natural pigmented marks can be charming, but for some, they are a source of aesthetic concern.
Thanks to modern techniques such as pigment laser, microdermabrasion, and gentle peels, it is possible to even out the complexion and reduce hyperpigmentation, resulting in more harmonious and radiant skin.
Freckles are caused by a very superficial deposit of melanin, the pigment that gives skin its color.
There are two types of melanin :
• Eumelanin, the brown pigment that increases during tanning.
• Pheomelanin, the red pigment, which increases in the case of freckles.
These small macules are absent at birth and appear between the ages of 5 and 15.
Freckles are primarily caused by a combination of genetic and environmental factors. The main causes are :
• Genetic factors : the predisposition to freckles is often hereditary. People with fair skin and red hair are more likely to develop them due to a genetic mutation that affects the regulation of melanin production. They are transmitted in an autosomal dominant pattern.
• Sun exposure : UV radiation stimulates melanin production in skin cells. Freckles appear as a result of this localized overproduction. This is why they are more visible in summer, after prolonged sun exposure.
• UV-sensitive skin : individuals with more reactive skin, particularly phototypes I and II, are at higher risk of developing freckles after even brief sun exposure.
In recent years, freckles have become a trend on social media. Celebrities and influencers like Kendall Jenner, Caroline Receveur, and Nabilla have embraced fake freckles. Many women and teenage girls wish to have them. This can be achieved through makeup or dermopigmentation.
It is important to remember that this is a passing trend, and makeup — being removable — is the preferred option.
To prevent freckles, sun protection is essential. Exposure to UV rays is the main trigger, so it is recommended to apply a broad-spectrum sunscreen with at least SPF 30 every day, even in winter or on cloudy days. Wearing wide-brimmed hats, sunglasses, and protective clothing can also help reduce direct sun exposure in summer.
Freckles can be perceived as a cosmetic concern. Several medical techniques are available to reduce their appearance. The appearance and worsening of these macules can be slowed by consistent sun protection. However, in genetically predisposed individuals (phototype I and redheads), preventing their appearance is impossible.
Treating freckles is mainly a personal decision based on aesthetic discomfort.
However, it is advisable to consult a doctor if you notice :
• A sudden increase in the number or size of freckles.
• Changes in color or texture.
• Spots that become painful, irritated, or raised.
Some freckles may be mistaken for more serious skin lesions.
Two types of lasers can improve the appearance of freckles :
• Ablative laser, which removes the pigment.
• Q-switched laser, which breaks down the pigment.
In both cases, 2 to 3 sessions spaced two months apart are required to achieve visible improvement.
Doctor Romano prefers the first option : laser peel. The advantage of this method is that it exfoliates the skin rather than simply removing the freckles. The skin becomes brighter and regenerated by removing surface dead skin cells.
This technique is the most effective and, when performed by an experienced doctor, does not cause post-inflammatory pigmentation — a common issue with Q-switched laser.
Peels are often considered for treating freckles, but their effectiveness is limited.
Superficial peels only act on the upper skin layers and cannot target deeper pigment.
Medium and deep peels, which penetrate further into the skin, offer more visible results.
However, these treatments carry potential side effects such as redness, prolonged irritation, or even scarring, making their use debatable.
The risks associated with more aggressive peels often outweigh the benefits, especially for a minor aesthetic issue like freckles.
Microdermabrasion is sometimes suggested for freckles, but its effectiveness remains very limited.
This technique exfoliates the upper skin layers using microcrystals or an abrasive tip, helping to remove dead cells and slightly smooth the surface.
Since freckle pigment lies deeper in the skin, this treatment is not well-suited.
In Geneva, freckles can be treated with medical aesthetic procedures, especially when they are considered too pronounced or unevenly distributed. The price per session starts at 300 CHF, whether for a specific peel or laser treatment. The method is selected based on the patient's skin phototype, the density of the freckles, and overall skin quality. A quote is provided during the initial consultation.
The outcome of freckle treatment depends on the type of treatment used and the depth of the pigmentation.
After a laser session, a noticeable reduction in the number and intensity of freckles is observed.
It is important to understand that even after successful treatment, freckles can reappear, especially if the skin is exposed to the sun again.
Sun protection is therefore essential to maintain long-lasting results.
Freckles may fade naturally in winter, when sun exposure decreases, but they generally do not disappear completely. Certain aesthetic treatments such as lasers, chemical peels or depigmenting creams can help reduce their appearance.
Yes, freckles that are already present will remain visible, but regular application of a broad-spectrum sunscreen (SPF 50+) limits the appearance of new freckles and prevents existing ones from darkening. Sun protection is essential to maintain an even complexion.
Yes, tanning stimulates melanin production, which can darken existing freckles or cause new ones to appear. Fair skin is particularly sensitive to this. Excessive sun exposure should therefore be avoided.
Freckles may fade over time or during less sunny seasons, but they are generally permanent. Targeted treatments can reduce them, but sun protection remains essential to prevent their return.
No, freckles are benign and result from a genetic predisposition and sun exposure. They are not linked to health issues. However, it is advisable to monitor any changes in color, shape or size, and consult a doctor if in doubt, to rule out any skin condition.
