Freckles and Skin Cancer

Do Freckles = Skin Cancer?

I've always had freckles, but I've noticed that an alarming number of new ones have popped up all over my face and chest. Could this be a sign of sun damage or skin cancer?

Dr. Jessica Wu

Freckles (“ephelids”) are a sign of previous sun exposure. While most freckles are not dangerous, they are an indication of sun damage. Freckles develop when the skin produces more melanin pigment in response to the sun’s ultraviolet (UV) rays. Think of this process as your skin’s attempt to protect itself from further sun damage. This is why freckles often fade in the winter, then darken in the summer, when there’s more sunlight.

Freckles are more common in fair-skinned individuals, who tend to sunburn easily and have difficulty tanning, while those with olive or darker skin tones can tan easily and have fewer freckles. Freckles usually begin appearing in childhood on areas of the body that are most exposed to sunlight (like the face, chest, and arms), and gradually accumulate over a lifetime of sun exposure.

A recent sunburn or visit to a tanning bed could trigger the onset of new freckles. In fact, freckles that appear after a sunburn (“sunburn freckles”) have been associated with an increased risk of melanoma skin cancer. These are most often found on the chest and shoulders, and are larger and darker than the light brown freckles seen in childhood.

Any change in your freckles or moles could be a sign of skin cancer or a precancerous condition, so I recommend a visit to your dermatologist, who can examine your new freckles and determine whether they need to be removed. In my office, I encourage my patients to have a complete skin examination at least once a year for a baseline, and to come in sooner if they notice any changes in their skin, such as new growths or existing growths that are getting larger, darker, or itch and/or bleed. Freckles or moles that show these changes may need to be removed and sent to a lab for a biopsy to determine whether they are cancerous.