Mole vs freckle: The difference between these skin spots

There are some distinct differences between the two.

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Lucinda Starr
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Freckles and moles are sometimes grouped together because they appear to be similar. Often, a mole and a freckle share similar colours which can make it pretty difficult to spot the differences.

But, while freckles and moles can share similar characteristics, there are some distinct differences between the two, including a distinction in how moles develop vs freckles.

Let's find out exactly what the differences are between moles and freckles, how they develop and when you should get your freckles and skin moles checked. Plus, we'll be running you through the ABCDE method of self-examination to ensure you're spotting any interesting skin cells or potential skin cancers early on.

What is a mole?

A mole, otherwise known as naevus, is a normal skin growth that occurs when pigmented cells called melanocytes grow in groups [1]. Moles tend to appear as small dark marks or skin-coloured little bumps on the skin.

Most people will develop around 10-40 moles on their skin throughout childhood and their teenage years and their appearance may change or even fade over time [2].

What is the difference between a mole and a freckle?

The main difference between moles and freckles is that moles are raised from the surface of the skin whereas a freckle tends to be flat on the skin [1]. A freckle typically appears as brown spots, unlike moles that can be black, brown, pink and the colour of the surrounding skin.

Unlike moles, the appearance of freckles develops as a result of sun exposure and you'll notice more freckles on areas of the skin that have been repeatedly exposed to the sun [3].

Although sun exposure can increase the number of moles on the skin, they typically appear due to your genetic makeup — meaning you're likely to have the same amount of moles as your parents.

Are skin tags similar to moles?

In a similar vein, skin tags are a common growth that can appear on the skin. Typically, they look almost like a wart and are connected to the skin by a small, thin stalk [8].

Often, a skin tag will be less than 2mm in size and you might notice more popping up as you age.

So, how are skin tags treated? Some skin tags will drop off on their own, but you can chat to your doctor about getting these skin tags removed if they're causing your trouble (such as catching on clothing).

What causes moles?

The development of moles is largely due to genetics and many moles appear at birth [4]. Genetic mutations are likely to play a role in the development of moles, where research indicates that 78% of people with moles had a genetic mutation of the BRAF gene [4].

However, many moles are developed after birth and individuals with fair skin who are more susceptible to sunburn are at an increased risk of developing moles and even malignant melanoma.

What causes freckles?

Freckles occur as a result of too much melanin production, which is the pigment that gives your skin its colour and complexion [5]. Melanin that is produced by skin cells absorbs and reflects ultraviolet rays (UV), therefore, protecting the skin from sun damage.

Fair-skinned people have less melanin, meaning melanocyte cells start to produce more melanin when the skin is exposed to the sun. This means when you're exposed to harmful UV rays there's a greater chance of developing freckles instead of getting a tan.

There are 2 types of freckles ephelides freckles and solar lentigines [5]. Ephelides freckles are the flat and dark brown spots that appear in areas that are most commonly exposed to the sun like the face, arms, neck and chest.

Solar lentigines are yellow, brown or red spots otherwise known as age spots or sun spots and they typically start presenting in adults over 40.

Can moles and freckles be cancerous?

Most moles and freckles are completely harmless and they don't tend to develop into cancer — it just means you have normal skin.

However, people with more than 100 moles are at higher risk of developing melanoma skin cancer and those who have had too much exposure to the sun, particularly in early childhood, are at an increased risk of developing moles.

Regardless of who you are, you should be regularly checking your skin every 3-4 months and speak to your doctor if you notice any changes [6]

Luckily, dermatologists have developed the ABCDE melanoma detection guide to help you self-examine your moles and freckles [7]. Ready to check your own skin at home? Here's what you need to look out for when checking your freckles and moles:

  • Asymmetry: Since most melanomas are asymmetrical, look for moles that don't match - if you draw a line in the middle of the mole, ask yourself if the two halves match.
  • Border: Melanoma moles typically have an uneven border so check to see if the mole has uneven or notched borders.
  • Colour: Benign moles typically present as single dark brown spots so be on the lookout for moles with multiple colours, different shades of brown or other colours like red, white and blue.
  • Diameter: Look for skin spots that are getting larger. If you perform regular skin checks you'll be able to notice if a particular mole is growing in size. Typically moles shouldn't be larger than a pencil eraser ‚Äî roughly 6 millimetres.
  • Evolving: If you notice a significant difference in shape, size, colour, elevation or if the mole starts to bleed, itch or crust this may be a warning sign of melanoma.

If you are worried or notice any of these warning signs from your self-examination get your moles checked immediately by a doctor. The sooner you catch something that doesn't look right (such as potentially cancerous moles), the sooner you can take steps to resolve it.

Do moles require treatment?

In general, normal moles don't require medical treatment as they are harmless and extremely common. However, if you've performed a skin check following the ABCDE melanoma detection guide and you spot a significant difference then yes, you should get your moles checked out.

Typically, a dermatologist will diagnose the mole and examine whether the mole is indicative of skin cancer or it's non-cancerous. Most of the time dermatologists don't treat moles unless they appear to be skin cancer, they bother the patient or they are causing pain or it is unattractive to the patient.

Depending on the diagnosis, a doctor or dermatologist may perform one of the following treatments:

  • Surgery to cut the mole out, particularly if the mole is deemed suspicious as skin cancer.
  • A biopsy to get more information on whether the mole is skin cancer.
  • Radiofrequency surgery is used for cosmetic removals of moles.
  • Cryotherapy a.k.a freezing.
  • Electrocautery a.k.a burning.

What about freckles?

Freckles generally don't need medical treatment either, as most of the time they aren't indicative of any skin cancers. However, too many freckles on the skin are likely due to too much sun exposure from UV rays, particularly for people with fair skin so it's a good idea to wear sunscreen every day.

Many people do want to remove freckles for personal reasons and there are treatment options out there like laser freckle removal, intense pulsed light laser treatment and broadband light laser treatment.

Just like with a mole check, if you start to notice your freckles changing shape, colour or size then speak to your doctor to make sure it's not any signs of skin cancer.

Can you fade the appearance of freckles?

There are plenty of ways to reduce the appearance of freckles and sun spots from non-invasive topical treatments using skincare ingredients to more intense treatments like laser removal — it all depends on what you're after.

Protection from the sun

Usually, freckles tend to fade on their own with age, but if you want to fade the appearance of freckles and pigmentation spots, limiting your exposure to the sun and wearing SPF50+ and protective clothing is your best bet.

You're also less likely to develop freckles if you're protecting your skin from harmful UV rays.

Chemical peels

Chemical peels can help fade freckles over time because the top layer of the skin is removed with the help of ingredients like glycolic and trichloroacetic acid.

Laser pigmentation removal

Laser pigmentation removal works for freckles, sun spots and other types of pigmentation on the skin by breaking down the areas of pigmentation without damaging the surrounding skin. As a result, freckles fade over time and even out the skin's complexion.

The bottom line is that moles and freckles are really common — particularly living in a sunny country like Australia where you're constantly exposed to the sun. However, this also means you should be performing regular self-examination checks to figure out whether your moles and freckles could potentially indicate skin cancer.

Topical treatments

There are a bunch of topical and prescription treatments on the market that can aid in fading pigmentation on the skin like freckles. Software's prescription pigmentation treatment uses a customised treatment to fade dark spots, melasma and hyperpigmentation using ingredients including prescription retinoids, niacinamide, azelaic acid and hyaluronic acid.

If you want to fade the appearance of freckles, book an online consult with Software's team of doctors to find out what tailored treatment works best for your skin type.

Photo credit: Getty Images

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