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What is it?

Freckles, melanocytic nevus or pigmented nevus, are small benign spots that appear on the skin and darken with sun exposure or during pregnancy. They are formed by pigmented cells (melanocytes) that are arranged like cobblestones in the surface of the skin. They can be flat lesions (freckles) or protruding (popularly badly called warts). They can have a variable color from pink to dark brown, black or bluish and may or may not have hair.

These melanocytes may undergo changes throughout life, either by sun exposure or spontaneously. Some of these changes (dysplasia) can increase the risk of degeneration in malignant cells and become a melanoma. For this reason, it is vital to take care of the nevi and be aware of the changes that may suffer or if they appear new.

They are preferentially found on the face, although they can appear on any part of the body exposed to the sun as the shoulders, arms, back and chest.

Who does it affect?

All humans have freckles, at least one. They can be present in newborns (1%), they usually start appearing from 6-12 months and increase in number and size up to 25 years. In adulthood, around 50-60 years, they tend to progressively lose pigmentation and may even disappear. They are more common in people with fair skin, blond or redhead who have been exposed to the sun actively or passively.

Symptomatology

Pigmented nevi are asymptomatic. The visual signs that should alarm are the black coloration, the fast growth or its irregularity in form or color. However, these signs usually appear in a relatively advanced period of the tumor. Ideally, it should detect the most incipient changes to avoid future risks by making an early prevention.

Causes

Pigmented nevi usually appear by genetic factors and / or environmental factors such as exposure to solar radiation.

It is very important to keep track of the nevi to detect any possible changes in size, shape, color or inflammatory changes, as they may be signs of suspected malignancy.

Types

We can differentiate between:

  • Congenital melanocytic nevus: are those who are already at the time of birth (1% of newborns). They can measure a few millimeters or occupy a large part of the body surface. They are associated with an increased risk for developing malignant melanoma, especially the larger ones (> 20 cm or covering a whole area of the body like an arm).
  • Acquired melanocytic nevus: are those that appear during childhood or throughout. They are the most common and usually appear in areas exposed to the sun.

Prevention

Although the vast majority of moles are benign and throughout life don’t become a skin cancer, it’s necessary to periodically check with the dermatologist as they may undergo changes. Most skin cancers usually appear on apparently healthy areas of the skin, with no lesions or previous freckles.

However, some melanomas (very aggressive skin cancer and particularly frequent in young people) can originate in an old freckles. The tool that allows the early detection of possible microscopic changes in the structure of nevus and achieve a very early diagnosis of skin cancer is digital dermatoscopy. A digital mapping of all the pigmented lesions of the patient is done through the 360º scanned scanner (Fotofinder Bodystudio). This study allows to detect possible signs of risk of cancer degeneration in each of the nevus and allows a very precise and reliable follow-up of the evolution of the freckles in each of the periodic reviews.

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Treatment

We will use one method or another depending on the type of lesion, location and purpose of the treatment. The possible treatments are:

  • Removal
  • CO2 laser