Children with freckles on their necks may be caused by hyperpigmentation or perifollicular keratosis, and it is recommended to consult a doctor in time. 1. Hyperpigmentation: children’s neck skin is relatively delicate, if they do not pay attention to sun protection when they go out, after ultraviolet sun exposure, it may lead to skin damage and melanin deposition, thus forming freckle-like spots. 2. Keratosis pilaris: when suffering from keratosis pilaris, the lesion of local hair follicles will produce small black spots like freckles, some patients don’t need to be treated, and it will get better with age, but some patients will also have pimples with the aggravation of the disease, which will lead to rough skin. If your child has freckle-like spots on the neck, it is recommended to consult a doctor in time for targeted treatment, so as not to delay the treatment and aggravate the condition.