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Your Beautiful Spots - Do You Know the Difference?

Moles, freckles, and birthmarks (aka beauty marks) — might look alike to you, but they’re very different. It’s important to know the characteristics that set them apart – so read on to find out how to “spot” the difference between birthmarks, moles, and freckles.

A basic explanation is that freckles are usually skin cells that have extra pigment (most often from the sun). Moles tend to be raised (but not always) and can increase in size from childhood. A birthmark can range from pigmented to vascular lesions that you’re born with. They are usually caused by an issue with cell migration during development.

What Is a Mole?

Moles are pigmented lesions. They can be flat and smooth or raised and bumpy, indicating 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, (pink, flesh colored, brown, black) and oval or round in shape. They occur almost anywhere on the skin. Typically, they develop before the age of 40, and some may disappear with age. If you’re born with a mole, it’s considered a birthmark.

According to the Mayo Clinic, most moles are harmless. In rare cases, moles may become cancerous. Monitor moles and pigmented skin patches for changes in shape or size. If the mole seems to be growing, or the boundaries go from a smooth shape to uneven or ridged, see a dermatologist or other qualified health professional. Moles can usually be removed easily for those who don’t want them for cosmetic reasons.

Where Do Freckles Come From?

After a day in the sun you notice spots around your nose and cheeks. They’re freckles, or ephelides - usually brown and flat – and caused by an increase in melanin, which gives skin its color. When the body senses the skin is becoming damaged by the sun’s UV rays, it produces more melanin in an effort to protect it. This shows up as a tan or patches of freckles in some areas. Certain skin types are more prone to freckles after sun exposure than others. In many 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 plastic surgeon Dr. Peter Schmid. “Freckles typically develop in individuals with very fair skin types.”

Help reduce your chances of freckling by wearing broad-spectrum SPF 30 or higher every day and reapplying at least every two hours, even when it’s overcast. 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.


Birthmarks are exactly what their name implies: marks on your skin from birth (or soon after birth). They come in all different shapes, sizes, and colors, and they appear anywhere on the skin. They may be so tiny and light colored as to be hardly noticeable, while others are larger and darker. Some remain permanently, others 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 neck in the infant. It can be of significant shape and size and grow hair.”

Experts don’t know exactly what causes birthmarks or why they appear, but in most cases they are harmless. As always, if you’re concerned, check with your dermatologist.

While birthmarks, moles and freckles are usually benign, it’s important to monitor all spots on your skin. Dermatologists recommend 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. 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, purple or black moles. They may develop as a new spot on normal skin or from a pre-existing brown mole.

When it comes to prevention, healthcare professionals recommend following the “ABCDEs” to help determine if a lesion may be melanoma.

A - Asymmetrical shape – the mole isn’t even or smoothly formed on all sides.

B – Border - an irregular, scalloped border.

C – Color – is the mole or spot uneven in color?

D – Diameter – is it larger than approximately 6 millimeters?

E- Evolving – growing abnormally in size, shape, or color.

If you have a spot or lesion on your skin that shows any of the signs listed on the ABCDE guide, see your doctor as soon as possible. And an annual checkup with a dermatologist or other qualified healthcare professional is important to maintain good health.

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