Facial freckles in child who has sunburned skin between the freckles.
Groups of freckles on nose and cheeks of fair-skinned child.
CLINICAL FEATURES
Freckles (ephelides) are acquired 1–5-mm light brown macules seen on sun-exposed skin. They first appear at 3 to 5 years predominantly on the face and extensor surface of the extremities. Freckles are seen in fair-skinned children with light or red hair as an autosomal dominant trait and are related to polymorphisms in the melanocortin 1 receptor. Freckles contain increased pigment in epidermal basal keratinocytes, but normal numbers of melanocytes. Freckles darken with more sun exposure and lighten with sun protection.
TREATMENT
Freckles are a sign of the need for sun protection as they are seen in children with an increased likelihood of sunburn, melanoma and nonmelanoma skin cancer. Sun protective clothing and hats, avoidance of midday sun, staying in the shade and use of high SPF sunscreens should be recommended for children with freckles.
