Question: Is there a difference between freckles and pigmentation?

Hi doctor, I am struggling to understand the difference between freckles and pigmentation (like the type of pigmentation you get from being exposed to the sun). I know that people can get "freckles" from the sun, but what about young children who have lots of freckles (particularly red-heads), who have not had a lot of sun exposure? Are freckles formed the same way as other pigmentation?

Answer

Freckles and pigmentation from sun exposure do develop from the same mechanism, which is an increase in the darker pigment melanin. People with very fair skin (and red-heads) have skin that is more sensitive to the sun and they form freckles very quickly from sun exposure. Freckles also has a genetic link but it takes exposure to UV-B radiation from the sun to cause them. It is very rare to be born with freckles. Pigmentation can also develop from other causes other than UV-B exposure such as hormonal causes (like pregnancy), or as a result of inflammation.

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