What are the differences between moles, freckles and liver spots?

Although moles, freckles and liver spots are all skin spots, they have different causes and properties. Moles, also known as melanocytic nevi, are essentially accumulations of pigment cells in the skin and are usually considered benign. Freckles, known in the medical world as ephelides, are also benign blemishes and are mainly caused by sun exposure. Liver spots, also called lentigines, are brown spots that develop under the influence of sunlight and can develop later in life. In this article, we’ll take a closer look at the differences between moles, freckles, and liver spots, and how to determine which spots are of concern and which aren’t.

What are the differences?

The 3 are better distinguished under the microscope (biopsy). With a freckle, the amount of pigment cells (melanocytes) are equal, only more pigment is produced.
A liver spot, also known as a sun spot, actually has nothing to do with your liver. In the medical world, a liver spot is also called lentigo. Lentigines (plural) contain both more pigment cells and more pigment. The pigment cells are evenly distributed in the lower layer of the epidermis.
In moles, there are also more pigment cells, but unevenly distributed and accumulated in the skin.


Freckles are small, flat spots on the skin that are caused by an increase in melanin, the pigment responsible for the color of our skin, hair and eyes. Most freckles are small and range in color from light brown to dark brown. They are usually about 1 to 2 millimeters in size, but can be up to 5 millimeters in size in some cases.

Freckles are mainly found on the face and sun-exposed areas such as the upper body, forearms and lower legs. They are formed under the influence of sunlight. That is why they become darker in color during the summer period and just lighter in the winter months. Most people recognize freckles very easily. They are more common in people with lighter hair color and skin type (red and blond hair).

Although freckles are usually harmless and do not require medical treatment, it is important to keep an eye out for changes in the size, color or shape of freckles as these changes may indicate skin cancer. People with lots of freckles should be extra careful in the sun and use sunscreen to protect their skin.

In addition to sun exposure, freckles can also be hereditary. People who have a parent with lots of freckles are more likely to develop freckles as well. In some cases, freckles can be reduced with treatments such as chemical peels or laser therapy, but these treatments are not always effective and have risks.

Moles Freckles Lentigo

Lentigo (Lentiginis plural)

Lentigines are brown spots and also arise under the influence of sunlight. These stains will not go away on their own. They can arise from puberty, then they are called lentigines simplex. Lentigines solaris or lentigo senilis (liver spot or age spot) are also benign variants that develop at a later age. You often see them on the backs of the hands and on the cheeks.

A common question about lentigines is whether these spots are malignant. Lentigines are generally benign and do not have cancerous properties. However, it is important to keep an eye on the spots and check regularly for changes in size, shape and color. If changes occur, it is wise to consult a dermatologist for further examination and possibly a biopsy.

Lentigines can also be confused with other pigment disorders such as freckles and moles. The main difference between freckles and lentigines is that freckles often appear in greater numbers and are darker in summer. Lentigines are darker and remain visible all year round.



Moles, also known as nevi, are pigment cells that have clustered in a particular area of ​​the skin. They can be present at birth or develop later in life and often become darker in color with exposure to the sun. Moles come in a variety of colors, such as black, brown, red, and skin-toned, and can have different shapes. Some moles are smooth and flat, while others are raised or spherical.

It is important to note that a light brown birthmark can sometimes be difficult to distinguish from a freckle or lentigo. It is therefore essential to have suspicious spots on the skin checked by a dermatologist.

Although moles are usually benign, it’s important to notice any changes in size, shape, or color. If a mole suddenly grows, changes shape, itches, bleeds or becomes painful, it is important to see a dermatologist right away. During puberty or pregnancy, existing moles can also suddenly increase in number or size. It is therefore important to check the skin regularly and to notice changes in the skin.

Moles Freckles
Moles Or Birthmarks

Suspicious birthmark – what are its features?

Recognizing a suspicious spot can be made easier by using the ABCDE rule for a suspicious mole. A stain is considered suspicious if it shows one or more of the following:

  • Asymmetry: One half of the spot or birthmark looks different from the other half.
  • Border: the spot or birthmark has an irregular and jagged edge.
  • Color/color: the spot or birthmark changes color or contains different shades of color.
  • Diameter: the spot or birthmark has a diameter greater than 5 millimeters.
  • Evolving/evolution: the spot or birthmark starts to itch, bleed or shows changes in appearance.

Bonus: age warts

Age warts are a common phenomenon of aging. Also called verruca seborrhoica, they are benign skin tumors. The number of seborrheic warts increases with age, but the cause of these warts is not yet known.

The warts have different colors, such as light brown, dark brown, black or skin-colored and have a cauliflower-like structure. They range in size from a few millimeters to a few centimeters, with an average size of 0.5 to 1 cm. The warts are scattered all over the body, but are mainly found on the trunk. The number of seborrheic warts can range from a few to hundreds. It is important to know that seborrheic warts are benign and do not pose a health risk.

Birthmarks Age Warts Lentigo
Age Warts

While you are here

Melanocytes also called pigment-producing cells. These cells are located in the lower layer of your epidermis, hairs and also in the iris of your eyes. Per square millimeter, between 1000 and 2000 melanocytes are found in the skin. That is about 5% to 10% of the cells in the basal layer of the epidermis. Although their size varies, melanocytes are typically 7 ɥm long and, like squid tentacles, interact with keratinocytes (skin cells). A melanocyte is roughly ‘connected’ to 40 keratinocytes. More about pigment cells

Picture of Dr. Francis Wu

Dr. Francis Wu

Dr. Francis Wu, een vooraanstaande dermatoloog, is de drijvende kracht achter Iconic Elements. Hij heeft sinds 2004 zijn expertise ingezet om een veilige en effectieve huidverzorgingslijn te creëren, geschikt voor zowel gezonde huid als huidproblemen. Iconic Elements, opgericht in 2016, is de eerste brede skincare lijn in Nederland ontwikkeld door een dermatoloog. Als medisch specialist streeft Dr. Wu naar het bevorderen van het welzijn van mensen door hoogwaardige en effectieve huidverzorgingsproducten te bieden. De proefdiervrije en vegan producten vermijden schadelijke chemicaliën en bevatten natuurlijke ingrediënten.
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