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For something so commonplace, freckles are a contentious topic. A genetic gift from Mother Nature, they’ve been both shunned and embraced by the fashion world, with even-toned complexions long deemed ideal, while freckles – real and faux – are sent down the catwalks in cyclical celebrations of diversity. But whether you love them or not, there’s more to know than whether they’re considered ‘on trend’.

Many of us refer to most small, dark marks on the face and body as ‘freckles’, but they’re not all what they seem. Consultant dermatologist Dr Daniel Glass, from The Dermatology Clinic told us that real freckles are most commonly found on younger skin from childhood. “There are three main types of skin pigmentation on the skin, including freckles, however these develop into different skin conditions as we grow older,” he explains. Confused? Here the skin authority takes us through the different types of pigmented lesions on your skin so you know what’s what.

1. FRECKLES

“A freckle is a small, pale to dark brown flat area of skin with a poorly defined border. They are caused by overproduction of melanin pigment by the melanocytes, which is in direct response to UV light exposure. This response occurs in people with a variant of a particular gene called MC1R. Visually, people with this variant have red hair and pale skin, and can burn more easily, and far quicker in the sunshine. Freckles are most prominent on sun‐exposed areas of the skin during the summer months, and tend to fade during the winter season.”

2. SOLAR LENTIGO

“As we develop and grow, our ‘freckles’ can change to become solar lentigoes; a flat, brown mark. These skin abrasions tend to accumulate with age as a result of sun exposure and, once they appear on the skin, they will not fade in winter months. They are not cancerous and can occur anywhere on the body, but most commonly on the forearms, back of the hands, shoulders and face. Solar lentigines that appear on the back at a later age have been linked to sunburn in this area in childhood. Sun avoidance, use of a broad spectrum, high factor sunscreen, and appropriate clothing lowers the possibility of new lesions emerging in the future.”

3. LENTIGO MALIGNA MELANOMA

“Both freckles and solar lentigines are harmless and completely benign, but it’s is often difficult to recognise the differences between these marks, and a type of skin cancer called lentigo maligna melanoma.

“This type of skin cancer also presents as a flat, brown or black, irregularly shaped lesion, but it grows very slowly. It occurs on areas of over-sun exposed skin such as the face, neck and forearms. So if you notice a brown spot with multiple colours or an irregular border, it’s important to seek medical advice as soon as possible, as a biopsy may be required.”

FRECKLED SKIN AND SUN EXPOSURE

“Avoid sun bathing and use of sun beds, and when out in sunny weather wear a sunscreen with both high factor (SPF50) UVB protection and UVA protection. You probably only need 10 or 15 minutes of sun on your face and forearms to get enough vitamin D in the summer. In the winter many people in the UK are vitamin D deficient and a supplement can be useful.”

TREATMENT OPTIONS

“Treatment isn’t needed for freckles and solar lentigines as they are totally harmless. However, if you’re unhappy with pigmented lesions on your skin, a dermatologist will be able to advise on a range of visual treatments. These include chemical peels and cryotherapy (liquid nitrogen freezing) to remove the lesions, laser treatments and lightening creams to reduce the appearance and intense pulsed light treatment, which balances uneven melanin levels.

“If you are concerned about any changing pigmented spots on your skin, you should seek advice from your dermatologist, who will also be able to arrange surgical excision of any lesions that may be of concern.”

So there you have it. We say honour, don’t hide your freckles – but practice safe sun exposure and don’t hesitate to seek medical advice if they change in appearance. Visit thedermatologyclinic.london for more tips.

This article originally appeared on Harper’s BAZAAR UK.