While moles are easier to distinguish, many people can’t tell the difference between freckles and sunspots. With sun-kissed freckles being fashionable again thanks to the ‘Meghan Markle effect’, it’s easy to ignore these hyperpigmented areas – however, skin cancer in its early stages may look exactly like these spots.
So what’s the difference?
Most freckles, sunspots and moles are classified as harmless, random marks. They’re caused by melanin, which protects your skin against sun exposure by absorbing ultraviolet (UV) radiation. Melanocytes are mature, melanin-forming skin cells that can be anywhere on your body. When they’re activated by sun exposure, melanocytes transform your skin into ‘a tan’ – or in many cases, into freckles and sunspots.
Freckles and sunspots are the results of melanocytes that get darker and are usually flat. Also known as ‘nevi’, moles are caused by melanocytes that grow in clumps and can be flat or raised on the skin.
Some sunspots, however, may look suspiciously like melanoma, the most deadly form of skin cancer. If you're not a dermatologist, you might be staring at a new mark on your skin and wondering whether it's merely a cosmetic issue or something worse.
What causes freckles, sunspots and moles?
Freckles are genetic, but can darken with age and sun exposure, while moles are caused by skin cells that grow together. Freckles and moles can develop from childhood, and tend to keep growing as you age.
Sunspots are caused by a combination of aging and sun exposure. These marks are most likely to appear after age 40, which is why sunspots are also known as ‘age spots’ or ‘liver spots’ (something of a misnomer as they have nothing to do with your liver!).
As a general rule, if you’ve noticed any spot that’s new to you, it's a good idea to have it checked as soon as possible by your GP or a professional skin cancer detection service.
Size, colour and location
In terms of size, freckles are usually smaller than 2mm, and can be red or brown, while sunspots are larger than 2mm and can be brown or black. Moles are usually smaller than 6mm in size and vary from shades of brown to black. However, you have a mole that’s larger than 6mm, it’s a good idea to have it checked regularly.
Freckles and sunspots are most commonly located where your body gets the most sun exposure. As for moles, you can find these individually or in groups anywhere on your body, including hard-to-spot places such as on the scalp, fingernails, toes and genitals.
Can freckles and sunspots become cancerous?
Freckles and sunspots are harmless marks on the skin that do not become cancerous simply because they exist. However, if you have freckles and sunspots, your skin type may be more prone to developing skin cancer.
Freckles are more common among people who have lighter hair or skin. Fair skin is more likely to develop skin cancer, due to a lack of melanin to protect against sun exposure and subsequent ultraviolet radiation.
Your skin must be exposed to the sun to develop freckles and sunspots, which increases your risk to the harmful effects of the sun’s rays. As a result, people who have these marks tend to have an increased risk of skin cancer.
When a beauty mark turns ugly.
Any freckle or sunspot that’s larger than 2mm stands a chance of being more than just a spot. What’s more, if you have a mole that has changed shape, colour, or size recently – or is irregular, ragged or uneven in shape - it may be more than a beauty mark. Moles can also bleed or become itchy, which may be signs of changes associated with skin cancer. Learn what to look for here.
Skin cancer in New Zealand.
Skin cancer is the most common cancer in New Zealand. New skin cancers total about 82,000 per year, compared to a total of 16,000 for all other types of cancer. Our skin cancer rates are the highest in the world - in fact, the incidence of melanoma in New Zealand and Australia is around four times higher than in Canada, the US and the UK1.
What’s more, research suggests that two out of three New Zealanders will develop non-melanoma skin cancer during their lifetime1. As for melanoma, over 4,000 Kiwis are diagnosed with this life-threatening skin cancer annually, and it leads to over 350 deaths a year - making it one of the most fatal forms of skin cancer for both men and women2.
Sources: 1. Environmental Health Indicators. 2019. Non-melanoma skin cancer deaths. [Factsheet]. Wellington: Environmental Health Indicators Programme, Massey University 2. Melanoma NZ: https://www.melanoma.org.nz/be-informed/understanding. 3. Healthline: https://www.healthline.com/health/what-are-freckles?insvid=16df162f15c4e81a--1571782463321
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