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 onsetEarly childhood

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

fade with age

Middle age

Accumulate with age

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Common after 50 

Stable

Skin typeCaucasians, Asians, skin type I-II.

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

Caucasians, Asians, skin type I–III
Areas affectedFace, neck, chest, armsSun-exposed skin, face, hands, forearms, chest back and shins
SizeSmall flat pigmented macules

1–2 mm and above

Larger than freckles

mm-cm in diameter

BordersIrregular, well definedWell defined
colorRed to light brownLight yellow to dark brown
NumbersFew to hundredsFew to hundreds
DurationFade with agePersist for life
Relation to seasonAre more prominent in summer but fade considerably or disappear in winterStable

don’t disappear in the winter

EtiologyGeneticEnvironmental
Melanocyte numberMore1–2.2 times more
Melanocyte sizeLarge, more dendritesNormal
Melanosome numberIncreasedNormal
Melanosome sizeLargerNormal
Epidermal rete ridgesElongatedElongated
Epidermal pigmentationIncreasedIncreased
OtherMelanin-laden macrophagesMelanosome complexes in keratinocytes

More mitochondria

Better-developed ER

Microinvaginations into keratinocytes

‘Pendulum melanocytes’

TreatmentApart 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

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