Hello there! How are you doing?

I'm Dr Peter Ch'ng and here's Episode 10 of our Patient Mailbox series. We collect handpicked questions submitted by patients suffering from various skin diseases and condition, and personally answer them with our best efforts. I hope to help any one of you who face challenges from similar situations.

Editor’s Note: Dr Peter Ch’ng is a Consultant Dermatologist actively involved in numerous talks and workshops, and is an esteemed contributor to dermatology research and publishing internationally. He practices at both Peter Ch'ng Clinic Skin & Laser Specialist in Desa Park City and Gleneagles Hospital Kuala Lumpur.

Question:

Hi Dr Peter,

I’m Wanie, I frequently take part in outdoor activities especially water activities, like diving and hiking. I practised these hobbies of mine for a few years until recently when I noticed my face is full of freckles, especially around my cheeks and nose.

I’ve asked around, and my friends and family told me that it is because of my time spent outdoors. Is this true?

If that’s the case, is there any way that I can get rid of these freckles? And how can I prevent them from appearing again with my outdoor lifestyle?

Answer:

Sunlight and freckles

First of all, it is indeed true that freckles or pigmentation on our face can be caused by or made worse by being outdoor under the sun for long periods of time.

In countries that have four seasons of spring, summer, autumn and winter, freckles on the skin tend to worsen during the summer, and get better during the winter.

In other words freckles and pigmentation on our skin become worse under sunlight and UV (ultraviolet) rays exposure, and will worsen the more exposed the skin is to sunlight, especially during the hours of late morning till afternoon (about 10am to 3pm).

In Malaysia, we have sunny weather all the time, so the freckles on our skin do not get better like in some countries during the winter and are present all the time.

Getting rid of freckles

To remove freckles from our skin and on our face, the safest and most effective treatment method is using lasers.

Freckles are formed at the surface of the skin, called the epidermis layer. So during a laser treatment, the laser peels off the pigments on the skin. This forms a thin crust on the skin of the treatment area after every treatment due to the peeling off of the freckle pigments.

After a few weeks, these crusts peel off on their own, leaving your skin freckle and pigmentation-free.

The lasers used in treatments to get rid of freckles are mainly pigmentation lasers that target the surface of the skin where the freckles are. These can be done by pigmentation lasers in Q-switch mode (nanosecond laser light), or in Picosecond mode.

Laser treatments are safe and effective if used correctly by a trained medical doctor, but can be dangerous and leave our skin exposed to risks of burns and injuries if operated by an untrained individual.

So make sure you get one at a verified skin clinic!

Laser treatment is the safest and most effective treatment to remove freckles. If you’re interested in getting one, call us at +6011-22882299, WhatsApp us here, or book an appointment with Dr Peter here!

Keeping freckles from coming back

However, after treatment, freckles may still reappear if our skin is exposed to sunlight or UV (ultraviolet) rays excessively again.

The main thing to do to prevent freckles from coming back again is still to avoid ultraviolet rays and practice diligent sun protection with sunblock or sunscreen routine everytime we are outdoors.

Additionally, topicals like cleansers or moisturisers that contain lightening effects also helps.

Freckles and pigmentation

Actually one surprising thing I have found out is that for freckles, many patients have had the skin condition for many years, and some even since they were young. So there are many of them who actually don't feel too unhappy with their freckles on their face.

This is because the freckles have become like an identity for them, making them recognizable for having these freckles. For them, the concern lies more on other skin condition that can come along with freckles, or that may look like freckles like other forms of pigmentations, scars, acne, and lentigines.

Hence, more importantly, we need to have a correct diagnosis of pigmentations and skin conditions to differentiate them between freckles and other conditions, especially lentigines which can look very similar to freckles.

Freckles are small, brownish or black pigments. They come in clusters and there are usually multiple freckles around the same skin area. Freckles often appear on the face and other areas that are often exposed to sunlight or UV (ultraviolet) ray.

Lentigines, on the other hand, are bigger, more well-defined, and have a more demarcated appearance.

Freckles are mainly caused by genetics, which is why we only see them in certain individuals since a young age, and are also more commonly seen among people with fair skin.

Freckles are also harmless, and they almost always won't turn into skin cancer, so it is usually not a huge cause for concern.

However, do know that if you wish to get rid of any freckles or pigmentation on your skin, there are treatments available but make sure you make the safe choice of getting it done by a medical doctor.

Look out for next week's entry as we look at some facts and myths about freckles!

Cheers.

*Editor’s note: As an esteemed dermatologist and skin specialist, Dr Peter is a renowned doctor in treating various skin conditions. He also prides himself in being able to treat acne patients of all types, with a 100% acne treatment success record. If you’d like to ask more about your skin condition or have a discussion with Dr Peter, call us at +6011-22882299, WhatsApp us here, or book an appointment with Dr Peter here!

---

If you’d like to ask more about your skin condition or have a discussion with Dr Peter, you can contact us at +6011-22882299, Whatsapp us, or book an appointment with Dr Peter here!