Health Conditions A-Z Skin, Hair & Nail Conditions Freckles on Your Wrist or Hand? Here's What Causes Them Sun exposure and genetics play a part By Christina Oehler Christina Oehler Christina is a New York City-based writer and commerce editor. She has worked at various publications including InStyle, Shape, Verywell Health, and Health. She also has a RYT-200 certification. health's editorial guidelines Updated on February 5, 2023 Medically reviewed by William Truswell, MD Medically reviewed by William Truswell, MD William Truswell, MD, FACS, operates his own cosmetic and reconstructive facial surgery practice. Dr. Truswell was the first in his area in Western Massachusetts to have an accredited private office surgical suite. learn more Share Tweet Pin Email Many skin conditions bother people and inspire them to search for answers on Twitter, the internet, or other social media. One common worry is having freckles on your hand or wrist. If you're concerned because you have them there, there's usually no need to worry. Those are common places for the familiar dots to show up. Read on to learn what causes them, what you should do, and when to see a healthcare professional. "We see tons of freckles on the hands and wrists," Debra Jaliman, MD, a New York City–based dermatologist and author of "Skin Rules," told Health. "That's just a very common place to find them on the body because of the sun exposure they receive." Who Gets Freckles? Freckles are extra pigmentation under the skin, and while they are sometimes present at birth, they usually form (or become more pronounced) due to sun exposure over the years. Researchers have found that two elements predicted the presence of freckles: frequent sunburns and a gene known as MC1R. MC1R tells the cells how much melanin to make. But the gene doesn’t affect all individuals the same way. There are two types of melanin: eumelanin and pheomelanin. Melanocytes produce both in the skin. These pigments make up our skin, eye, and hair color. Eumelanin is a black-brown pigment in dark hair, skin, and eyes. Eumelanin protects the skin from UV radiation, and a lack of it leaves skin vulnerable to the sun damage that causes melanoma. On the other hand, pheomelanin is a reddish-yellow pigment responsible for red hair, green eyes, pale skin, and freckles. It is these types of melanin that determine how many freckles you have. Researchers have learned that redheads have less eumelanin and more pheomelanin, resulting in fair skin. Why the Wrist and Hands? Freckles commonly appear on your hands and wrists, as it turns out. "A wrist is somewhere people wouldn't think to wear sunscreen, Dr. Jaliman explained. "Maybe if you're on the beach, you'd get that area covered while applying sunscreen to your arms. But if you're wearing clothing, the hands and wrists aren't somewhere, people would think to apply sunscreen." The same goes for the hands. A study of 214 beach-going people found that less than half applied sunscreen to the tops of their hands. This is of concern because the skin on the top of the hands is a known site for developing cutaneous squamous cell carcinoma. Studies show that skipping easy-to-miss spots when applying sunscreen is an easy and common mistake. Use sunscreen every day to help reduce your risk of skin cancer and prevent wrinkles, dark spots, freckles, and other signs of premature aging.A small 2018 study suggested applying sunscreen twice before going out in the sun to maximize the area you cover. Freckles and Cancer Risk Rachel Nazarian, MD, a New York City–based dermatologist and Fellow of the American Academy of Dermatology (FAAD), previously told Health that while freckles aren't always a cause for concern, they can be precursors to cancer. Check your skin regularly, and if you notice a freckle changing color or shape, have it checked out by a dermatologist. Anyone can get skin cancer, but people with specific characteristics are at greater risk. These include: Skin that burns, freckles, reddens easily, or becomes painful in the sun A lighter natural skin color Blue or green eyes Blond or red hair Certain types of moles, or a lot of them A family history of skin cancer A history of skin cancer Older age A Quick Review It's not uncommon to have freckles on your wrists or hands. They get there because the area gets a lot of sun exposure, and those are easy places to forget when applying sunscreen. Use sunscreen on your hands and wrists (and the rest of your skin!) to prevent sun damage and more freckles. If you notice your freckles changing shape or color, have a healthcare professional check them out. Types of Skin Lesions and Their Causes Was this page helpful? Thanks for your feedback! Tell us why! Other Submit Sources Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Shirbeigi L, Zareie E, Ranjbar M. Evaluating the causes of freckle and nevus from the viewpoint of Iranian traditional medicine. Iran J Med Sci. 2016;41(3 Suppl): S67. Smit AK, Collazo-Roman M, Vadaparampil ST, et al. MC1R variants and associations with pigmentation characteristics and genetic ancestry in a Hispanic, predominately Puerto Rican, population. Sci Rep. 2020;10:7303. doi: 10.1038/s41598-020-64019-y Schlessinger DI, Anoruo M, Schlessinger J. Biochemistry, melanin. In: StatPearls. StatPearls Publishing; 2022. Nasti TH, Timares L. Mc1r, eumelanin, and pheomelanin: their role in determining the susceptibility to skin cancer. Photochem Photobiol. 2015;91(1):188-200. doi. /10.1111/php.12335 Fino P, Spagnoli AM, Ruggieri M, Marcasciano M, Scuderi N. Bilateral hand squamous-cells carcinoma in patient affected with non-Hodgkin lymphoma. Case report and literature review. G Chir. 2015;36(4):172-182. doi: 10.11138/gchir/2015.36.4.172 Warren DB, Riahi RR, Hobbs JB, Wagner RF. Sunscreen use on the dorsal hands at the beach. J Skin Cancer. 2013;2013:269583. DOI: 10.1155/2013/269583 Heerfordt IM, Torsnes LR, Philipsen PA, Wulf HC. Sunscreen use optimized by two consecutive applications. PLoS One. 2018;13(3):e0193916. doi: 10.1371/journal.pone.0193916 American Academy of Dermatology Association. Confused about sunscreen? New American Academy of Dermatology survey shows Americans need a refresher on sunscreen application and SPF. Centers for Disease Control and Prevention (CDC). What Are the Risk Factors for Skin Cancer?