Is That Spot a Birthmark, Mole or Freckle? Here’s How to Tell

Moles, freckles and birthmarks (also known as beauty marks) — they might all look similar, but they’re very different. While these pigmented lesions on your face and body may have some resemblance to one another, there are many characteristics that set them apart. It’s important to know what each mark on your skin means, and to watch for any changes that could indicate skin cancer. Read on for tips on how to spot the difference between birthmarks, moles and freckles, and how to know if you need the marks checked by a dermatologist. 

The Difference Between Birthmarks, Moles and Freckles

“In simplest terms, freckles are usually skin cells that have extra pigment, often from the sun,” says Dr. Dhaval Bhanusali, a board-certified dermatologist in New York City. “Moles tend to be raised (though not always) and increase in size from childhood. Birthmarks can range from pigmented to vascular lesions that you are born with. They are usually caused by an issue with cell migration during initial development.”

What Is a Mole? 

As Dr. Bhanusali mentioned, moles are pigmented lesions. They can be flat and smooth or raised and bumpy, and they indicate areas of skin where pigment has clumped together. According to the American Academy of Dermatology (AAD), moles are usually small in size — less than the size of a pencil eraser — and can be different colors, including pink, skin-colored or black, and in shapes like oval and round. You can find them just about anywhere on your skin: your face, scalp, armpits and even the tiniest spaces between your toes and fingers. Typically, they develop during childhood and adolescence, and some may even disappear with age. Keep in mind that if you are born with a mole, it is considered a birthmark.

How to Get Rid of Moles 

According to the Mayo Clinic, most moles are harmless. In rare cases, moles may become cancerous. The key is to monitor your moles and other pigmented patches for changes that may indicate melanoma (more on that later). If you’re looking to get rid of your mole, the AAD recommends seeing your dermatologist. 

Where Do Freckles Come From?

Have you ever spent the day outdoors only to come back inside and notice spots around your nose and cheeks? Those spots, which are usually brown and flat, are called freckles. They are also known as ephelides and are caused by an increase in melanin, which gives our skin its color. When your body senses your skin being damaged by the sun’s UV rays, it produces more melanin in an effort to protect it from harm. This may result in an all-over color — like a tan — or small patches of freckles in some areas. Those with light-colored skin may be more prone to freckles when exposed to the sun. In some cases, reduced sun exposure may fade the intensity of your freckles.

“Freckles are commonly seen in youth and are spot-like, flat pigmented speckles where the pigmented cells of the skin called melanocytes become active in response to ultraviolet sunlight,” says Dr. Peter Schmid, a board-certified plastic surgeon. “Freckles typically develop in individuals with very fair skin types.”

How to Prevent Freckles

If you don’t like the look of your freckles, you can help reduce your chances of getting them in the first place by wearing broad-spectrum SPF 30 or higher every day and reapplying at least every two hours, even when it’s overcast. We recommend the SkinCeuticals Daily Brightening UV Defense Sunscreen SPF 30, which protects against UV rays and can help lighten current signs of sun damage. For added protection, wear protective clothing, seek shade and avoid peak sun hours — between 10 a.m. and 2 p.m. — when the rays are strongest.

What Is a Birthmark?

True to their name, birthmarks are exactly what they sound like: marks on your skin from birth (or soon after birth). They come in all different shapes, sizes and colors, and they can crop up anywhere on the skin. Some may be so little and flesh-colored that you won’t notice them without a magnifying lens, while others are bigger and darker in appearance. Some stay on the skin permanently, while others may disappear over time.

“Birthmarks are moles present at birth or in the early childhood years as red or blue-ish vascular or pigmented lesions,” says Dr. Schmid. “A common birthmark named the ‘stork’s bite’ is a reddish patch at the base of the infant’s neck. It can be of significant shape and size and grow hair.”

What Causes Birthmarks?

As for what causes birthmarks, the answer isn’t quite clear. The good news is that birthmarks are usually harmless, but if you’re concerned about one, it’s always smart to check with your dermatologist.

How to Check Your Spots for Melanoma

While birthmarks, moles and freckles are typically harmless, it’s important to monitor all spots on your skin to help ensure they don’t transform into something worse, like melanoma. Dr. Schmid notes that all types of lesions should be medically evaluated due to their predisposition to advance to cancer at a later age.

“Skin cancer can often mimic benign-appearing skin growths,” he says. “Skin lesions that demonstrate progressive growth, change in color, itch, burn, appear crusted, develop into a red patch, form a sore, bleed, ulcerate or demonstrate poor healing characteristics should be examined by a professional physician or skin-care expert. Typically, melanomas present as darkly pigmented, purplish or black moles. They may develop as a new spot on normal skin or from a pre-existing brown mole.” 

When it comes to checking your spots and marks, Dr. Schmid recommends following the “ABCDEs.” This ABCDE guide can help determine if a mole or spot may be melanoma.

A - stands for asymmetrical shape, meaning your mole isn’t even on both sides.

B - stands for border. Look for moles with irregular, scalloped borders.

C - stands for color. Does your mole have an uneven color?

D -  stands for diameter. Is your mole larger than about 6 millimeters?

E-  stands for evolving. Regularly check to make sure your mole isn’t growing abnormally in size, shape, or color.

Have a spot that’s painful or itchy? The Mayo Clinic recommends getting a checkup with your dermatologist. If you have a spot on your skin that shows any of the signs listed on the ABCDE guide, schedule an appointment with your doctor ASAP. Even if you think your spot seems fine, it’s always in your best interest to see a dermatologist for an annual spot check for safe measure and peace of mind.

Photo: Chaunte Vaughn

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