Freckles vs Lentigines: What is the difference in two?

Ephelides (freckles) and lentigines, are important pigmentation characteristics observed in humans. Both are affected by sunlight; ephelides (freckels) are largely genetically determined but induced by sunlight, whereas lentigines are induced by sun exposure and photodamage of the skin. However, despite being commonly observed, we know very little about them. The following table summarize the main differences between ephelides and lentigines:

  Freckles (Ephelides) Lentigines
Age of onset Early childhood

First visible at 2–3 years of age after sun exposure

fade with age

Middle age

Accumulate with age

Common after 50 

Stable

Skin type Caucasians, Asians, skin type I-II.

Fair skin, especially with red or blond hair and blue eyes.

Caucasians, Asians, skin type I–III
Areas affected Face, neck, chest, arms Sun-exposed skin, face, hands, forearms, chest back and shins
Size Small flat pigmented macules

1–2 mm and above

Larger than freckles

mm-cm in diameter

Borders Irregular, well defined Well defined
color Red to light brown Light yellow to dark brown
Numbers Few to hundreds Few to hundreds
Duration Fade with age Persist for life
Relation to season Are more prominent in summer but fade considerably or disappear in winter Stable

don’t disappear in the winter

Etiology Genetic Environmental
Melanocyte number More 1–2.2 times more
Melanocyte size Large, more dendrites Normal
Melanosome number Increased Normal
Melanosome size Larger Normal
Epidermal rete ridges Elongated Elongated
Epidermal pigmentation Increased Increased
Other Melanin-laden macrophages Melanosome complexes in keratinocytes

More mitochondria

Better-developed ER

Microinvaginations into keratinocytes

‘Pendulum melanocytes’

Treatment Apart from sun protection, no particular treatment is necessary. Cryotherapy

Laser surgery

creams that include retinoids and bleaching agents in them

References:

Praetorius, C., Sturm, R. A. and Steingrimsson, E. (2014), Sun-induced freckling: ephelides and solar lentigines. Pigment Cell Melanoma Res., 27: 339–350. doi:10.1111/pcmr.12232