Freckles are small, flat, light brown spots that appear on sun-exposed skin. Freckle removal treatments aim to lighten them and even out skin tone rather than erase them completely. Medically, freckles are called ephelides. They are usually a few millimeters across and tend to appear in clusters.

They are most common on the face, especially across the nose and cheekbones, as well as the shoulders, arms and upper back. They usually first appear in childhood, in the years when skin first gets significant sun exposure. They darken and multiply in summer and fade noticeably in winter.

Freckles are harmless and are not a disease. Many people embrace them as part of their natural look. Freckles treatment is a cosmetic choice for those who are bothered by their appearance. The plan is shaped around your expectations and your skin.

Two main factors cause freckles: genetics and sunlight.

• Genetics: The tendency to freckle is largely inherited. Freckles are more common in people with fair skin, red or blond hair and light-colored eyes.
• Sunlight: Ultraviolet rays stimulate melanocytes, the cells that give skin its color. In people prone to freckles, these cells produce more pigment in certain spots.
• Burning easily: Skin that burns easily and tans with difficulty is more prone to freckles.

With freckles, the number of melanocytes does not increase; the same cells produce more pigment when the sun stimulates them. That is why freckles fade when skin is protected and darken again with sun exposure. A summer spent outdoors without sunscreen can make freckles darker within a short time.

Freckles and sun spots are often confused, but they differ in several ways:

• When they appear: Freckles usually start in childhood. Sun spots develop with years of accumulated sun damage, mostly in adulthood.
• Size and color: Freckles are small and light brown. Sun spots are often larger and may be darker.
• Seasonal change: Freckles fade in winter. Sun spots do not change much with the seasons.
• With age: Freckles may become fewer with age in some people. Sun spots tend to increase with age.

Spots that appear in adulthood and don’t fade in winter may be a different type, such as age spots. Spots that grow, change color or shape, itch or bleed should be assessed by a dermatologist before any treatment is considered.

At your consultation, your doctor checks that the spots really are freckles and assesses your skin type and sun habits. A suitable method is then chosen. At our Nişantaşı clinic, these options may be considered to lighten the look of freckles:

• BBL laser: BBL laser uses broadband light to target pigment in the skin. Freckles darken for a few days after treatment, then may flake off as fine crusts.
• RedTouch Pro: Because its wavelength is also absorbed by melanin, RedTouch Pro may help lighten the look of uneven pigmentation.
• Chemical peel: A chemical peel renews the top layer of the skin in a controlled way and may help reduce surface pigment.
• Home care: Spot-correcting products recommended by your doctor and sunscreen are an essential part of treatment.

For light and laser treatments, the skin is cleansed, your eyes are protected with special goggles and a cooling gel may be applied. A session usually takes 15–30 minutes, depending on the size of the area. You may feel a brief stinging and warmth; mild redness afterward usually settles within a few hours.

The method and number of sessions depend on how dense the freckles are and how your skin responds. For other types of pigmentation, see skin spot treatments. Because the tendency to freckle is genetic, treatment does not remove it, and lightened freckles may return without sun protection, so expectations are discussed openly at your consultation.

Sun protection is the foundation of any freckles treatment. Even without treatment, regular protection helps keep freckles from darkening and reduces new ones:

1. Use a broad-spectrum, high-SPF sunscreen every day, including in winter and on cloudy days.
2. Apply it before going out and reapply every two hours if you are outdoors for a long time.
3. Try to stay in the shade around midday, when the sun is strongest.
4. Wear a wide-brimmed hat and sunglasses.
5. Avoid tanning beds.

Apply enough sunscreen to every sun-exposed area, not just the face: neck, ears, shoulders and the backs of the hands. Reapply after swimming or sweating. Children who freckle easily should also be protected from an early age, which may also lower the risk of sun spots and other sun-related skin problems later on.