What's the difference between a freckle and a mole? I know moles can become cancerous, but what about freckles?

Answers from Lawrence E. Gibson, M.D.

Freckles and moles are areas of increased pigment (melanin) in the skin — but they're not the same thing.

Freckles are small, flat, pigmented spots on the skin. They vary in color from red to tan to brown. Freckles aren't present at birth. Instead, they develop in time as a result of sun exposure. Freckles occur primarily in sun-exposed areas of the body, such as the nose and shoulders. Freckles rarely develop into skin cancer. However, freckles are especially common in people who have light skin — and having light skin that burns easily increases the risk of skin cancer.

Moles (nevi) are clusters of pigmented cells (melanocytes). Although they often appear as small, dark brown spots, moles come in a range of colors and sizes. They can be raised or flat and can develop almost anywhere on the body — even between the fingers and toes. Unlike freckles, moles can be present at birth. They often become more prominent with age. Moles also may darken with repeated sun exposure or as a result of hormonal changes in pregnancy. Most moles are harmless. Rarely, a mole may become cancerous.

Normally, freckles and moles pose no concerns. Be aware of early warning signs, however. If you have a pigmented lesion of any type — whether you think it's a freckle or a mole — that changes in size, shape or color, or becomes painful, consult your doctor.

Oct. 08, 2008