Frackles (2 of 2)

Frackles:

How important is heredity with freckles?

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Heredity and skin type are very important factors for the tendency to develop freckles. Freckles tend to be inherited genetically and are most common in individuals with fair skin and/or with blond or red hair.

Research in twin siblings, including pairs of identical twins and pairs of fraternal (nonidentical) twins, have found a striking similarity in the total number of freckles found on each pair of identical twins. Such similarities were considerably less common in fraternal twins. These studies strongly suggest that the occurrence of freckles is influenced by genetic factors. The variations in freckle counts appear to be due largely to heredity.

Ongoing research in a rare disease called xeroderma pigmentosum has also confirmed the genetic tendency of freckles. Excessive freckles in dark-haired individuals are quite common in this disease.

Further, freckles are also found in skin folds like the underarms in another uncommon genetic disease called neurofibromatosis.

What is the medical meaning of freckles?

True freckles pose essentially no health risk at all. They are all absolutely harmless. They are not cancerous and generally do not become cancerous.

Rare concerns about freckles may arise when they are associated with other diseases like xeroderma pigmentosum and neurofibromatosis or when they are confused with the following, more serious conditions:

• Lentigo maligna ("malignant freckle"): This is an uncommon fairly superficial skin cancer that generally occurs on the faces of older adults who have a history of considerable sun exposure. Over the course of months to years, this condition may, if untreated, develop into a more aggressive malignant variety called lentigo maligna melanoma. There are, of course, many hundreds of ordinary facial freckles for every one that is potentially malignant. A simple in-office test called a skin biopsy can help diagnose lentigo maligna.
• Melanoma: This very dangerous form ofskin cancer may appear even in young people and on parts of the body that are sun-exposed as well as those that are protected. While the exact cause ofmelanoma is not entirely known, ultraviolet rays (particularly UVA) are known to play a part. Melanomas can arise from a previously normal mole or pigmented spot that has been present many years or lifelong. Melanomas can also arise from completely normal skin without an apparent preexisting mole. In comparison with benign (noncancerous) freckles, melanomas tend to be larger, darker, and have more irregular color and shape variations. Most melanomas are actually flat and not raised as many people tend to incorrectly assume.
• Basal cell carcinoma: This is the most common type of skin cancer. These are usually pearly, pink or reddish in color, and may bleed easily. Pigmented basal cell carcinoma is a type of basal cell that may be confused for a freckle or seborrheickeratosis because of its brown or dark color. A simple procedure called a skin biopsy can help diagnose this growth.

A warning

Anyone who has one or more uncertain pigmented spots should have their physician or dermatologist evaluate them. Even verbal descriptions and photographs cannot convey enough information for satisfactory self-diagnosis. As always, it is better to be safe than sorry.

The American Academy of Dermatologyrecommends a full-body skin examination for adults as part of a routine annual health exam. It is important to have any new, changing, bleeding mole or growth examined by your physician or dermatologist as soon as possible. Skin cancers are curable if diagnosed and treated at an early stage.

How can freckles be prevented?

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Since we cannot change our own genetic component of freckling, our main preventionmeasures are aimed at sun avoidance and sun-protection, including

1. use of sunscreens with SPF (sun protection factor) 50,
2. use of wide-brimmed hats (6 inches),
3. use of sun-protective clothing (shirts, long sleeves, long pants),
4. avoidance of the peak sun hours of 10 a.m. to 4 p.m.,
5. seeking shade and staying indoors.

Freckle prevention is more effective than freckle removal. Freckle-reduction treatments are more difficult and not always satisfactory. People with known hereditary tendencies of freckling should start sun protection early inchildhood. Much of the sun and UV skin damage occurs often while children are under age 18.

Fair-skinned people who are more prone to freckling and sunburns are also generally more at risk for developing skin cancers. Freckles may be a warning sign of sensitive skin that is highly vulnerable to sunburn and to potential skin cancer.

What is the treatment for freckles?

Several safe and effective methods are available to help lighten or reduce the appearance of freckles. Frequently, multiple or a combination of treatments may be required for best results. Not everyone's skin will improve with similar treatments, and freckles can easily recur with repeated UV exposures.

1. Bleaching or fading creams: Products containing hydroquinone and kojic acid can be purchased with and without a prescription. Higher concentrations of hydroquinone (over 2%) require a prescription. These products can help lighten freckles if they are applied consistently over a period of months. Bleaching or fading creams are most effective in combination with sun avoidance and sun protection.
2. Retinoids: Sometimes used in conjunction with other bleaching creams, tretinoin(vitamin A acid, Retin-A), tazarotene(Tazorac), and adapalene (Differin) also may help lighten freckles when applied consistently over a period of several months.
3. Cryosurgery: A light freeze with liquid nitrogen in the physician's office can be used to treat some types of freckles. Not all spots respond to freezing or burning.
4. Laser treatment: Multiple types of lasers may help lighten and decrease the appearance of freckles safely and effectively. Like cryosurgery, this is a simple and safe procedure with a high success rate and a low risk of scarring or skin discoloration.
5. Photofacials or Intense Pulsed Light treatments are another method to lighten and remove freckles. This is not a true laser technique but an intense light source.
6. Chemical peels can also help lighten freckles and improve irregular pigmentation.

What is the value of freckles?

Some people like their freckles, while others may be more bothered by their appearance. The cosmetic improvement of the skin is a frequent request among people with freckles. On the other hand, freckles are desirable by some people who like the special character or uniqueness these give them.

Concluded.