Q: Should I be concerned that my face and back have more freckles every year? And is there a safe way to make them fade?
A: If you like your freckles, there’s no need to worry. Freckles are harmless pockets of the skin pigment melaninthat become prominent on sun-exposed areas of the body. Abundant freckling does not mean that you will develop skin cancer, but it does suggest that your skin is sun-sensitive and your risk for skin cancer may be elevated. Use sunscreen, wear a wide-brimmed hat and limit exposure to midday sun to help prevent existing freckles from darkening, keep new freckles from developing and reduce your skin cancer risk. If any freckle or other spot looks strange — lumpy, scaly, reddish, unusually large — see your dermatologist.

Don’t even think of rubbing lemon juice on freckles in an attempt to lighten them. This old folk “remedy” can make skin blister or break out in a rash when you’re in the sun. Instead, try an over-the-counter fade cream, such as Ambi or Porcelana, with 2% hydroquinone… or a prescription 4% hydroquinone cream. These work by blocking the synthesis of new melanin (not by bleaching existing spots) — so it may take several months of daily use for old melanin to migrate out through the natural process of exfoliation.

For faster and more thorough results, see your dermatologist for laser therapy. It works by using specific wavelengths of light to break down the melanin, which is then expelled from the surface and also carried away by your body’s lymphatic system. Most people experience mild discomfort from the laser procedure, so your doctor may use a numbing cream on your skin before starting. Usually one session eliminates or substantially reduces existing freckles (though future sun exposure may create new ones). A session typically costs $500 to $1,500, depending on the size of the area treated, and generally is not covered by medical insurance.

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