Your freckles

I like my freckles. In fact, I love them. Growing up in a particularly freckly family, I was always told that birthmarks and 'blemishes' are cute and give you character. So you can imagine my surprise when a friend of mine announced proudly, "I’m lucky – I don’t have any freckles".

Now I’m quite aware of Hollywood’s airbrush-them-out approach to freckles – the hours celebrities spend blotting out "flaws" with concealer, plus the post-production edits. Still, I always thought that we "ordinary" people weren’t buying what they were selling. Apparently we are.

The fact is that most people have a few smatterings of freckles, especially those of us with fairer skins. Some of us even have more than our share and are sprouting small constellations of spots from head to toe.

But in Hollywood, freckles are so not fashionable. Not unless you’re auditioning for the role of Orphan Annie. Still, believe it or not, many famous models and actresses are hiding oodles of dots beneath those layers of bronzer.

Freckle fabulous
Then there are the fabulous few who aren’t afraid to bare their freckles – think Lindsay Lohan and Lucy Lieu. Lieu in particular is proud of hers – so much so that she’s been known to fend off makeup artists in their defence.

Audrey Hepburn was another freckled starlet. And although she often kept her freckles hidden, she let it all hang out while starring alongside Humphrey Bogart in the movie, The African Queen.

But what are freckles anyway, and what causes them?

What they are
Freckles are heavy deposits of melanin (a skin pigment) that cause flat circular spots on the skin. They come in various colours, including yellow, tan, light-brown, brown and black.

There are two types of freckles, namely ephelides and lentigines. Whereas ephilides typically appear during summer and then fade again in winter, lentigines are darker spots that are visible all-year round.

What causes freckles
"There are many causes, but the most common is damage by sunlight, plus a genetic predisposition," explains Dr Susan Jessop, a dermatologist who works at Groote Schuur hospital.

Freckles form as a protective response to the sun’s rays, and tend to be more common in people with fairer skins. "This is because their melanin is less effective in protecting their skin from harmful rays," explains Jessop.

Are they dangerous?
The short answer is no; freckles in themselves are not dangerous. On the other hand, freckling does indicate that a person is more sensitive to the sun, and should take strict precautions to avoid future sun damage. "Remember that freckles are a sign that UV light is damaging your skin," advises Jessop. "Most common freckles tend to fade in winter - don’t let them recur in summer".

Although they are usually harmless, older people can develop malignant freckles. For this reason, you should go and see a dermatologist immediately if one of your freckles becomes raised or irregular.

What about freckle removal
If you aren’t so keen on your spots, there are ways to remove or lighten them.

Topical creams or skin "lighteners"
To avoid invasive or potentially painful procedures, try a cream or skin lightener containing one or more of the following ingredients:

• Hydroquinone
• Alpha and beta hydroxyl acids
• Arginine
• Stearic acid
• Arbutin
• Bearberry extract
• Mulberry root extract
• Vitamin A
• Vitamin C.

These ingredients slow down the production of melanin, thereby lightening freckles and uneven pigmentation.

Chemical peels
Peels are chemical solutions that are applied to the affected areas. They remove the outer layers of the skin so that new cells can grow and replace the freckled skin.

Superficial treatments such as glycolic acid peels leave very little redness. But medium peels such as TCA 20% are more aggressive and cause inflammation, redness, and sometimes scabbing, for up to 10 days.

The most aggressive chemical peel is a phenol peel, which causes discomfort and pain. "This should only be performed by a medical doctor, and with the patient under sedation," cautions Dr Alec Nikolic, Health24’s anti-aging expert. This peel will cause swelling and inflammation for up to 10 days, as well as scabbing and weeping.

Lasers
"All technology-based treatments use light as a source of energy to literally burn the pigmented lesions or freckles," explains Nikolic.

How does this work? Light consists of different colours; and each colour has its own wavelength. Because pigmentation absorbs certain wavelengths, the energy contained in the wavelengths is converted to heat energy. The heat then destroys the pigmented cell.

After treatment, laser therapy causes freckles to lighten as they heal, or to peel away leaving behind normally pigmented skin.

Cryotherapy
This involves freezing freckles with liquid nitrogen. Cryotherapy causes the surface of the skin to blister and peel, so that the freckle lifts and falls off. The process is often used to remove malignant age spots.

But why bother?
The fact is that freckles can be beautiful. So forget 101 Dalmatians and geeky prepubescent boys – learn to love the skin that makes you unique. Besides, people often associate freckles with fun-loving, friendly personalities – and what’s not to love about that?

Sources: Encyclopaedia Britannica; health-cares.net; www.freckles.org; Dr Alek Nikolic; Dr Susan Jessop

(Donna Warnett, Health24, January 2009)