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Actinic keratoses or solar keratoses

What is actinic keratosis or solar keratosis?

Actinic keratoses, or solar keratoses, are dry scaly skin patches, which can look like horns or spikes, and can be itchy.

An actinic keratosis is caused by many years of sun damage and is usually seen in people over 40. Around 1 in 4 people in the UK aged 60 and over has actinic keratoses.

The patches of skin can be pink, red or brown and are 0.5 to 3cm wide.

Actinic keratoses are usually seen on patches of exposed skin, such as the nose, forehead, neck, forearms, backs of hands and legs beneath the knees. They can also affect the tops of the ears, and the top of the head in balding men.

The skin patches are usually harmless, but in rare cases can develop into squamous cell carcinoma skin cancer.

Close-up of actinic keratosis skin lesion

Diagnosing actinic keratoses or solar keratoses

A doctor will inspect the skin patches and can often make a diagnosis based on their appearance.

This may be confirmed by sending off a skin sample for laboratory testing.

If the actinic keratoses are not causing problems or discomfort, a doctor may recommend monitoring the condition rather than treatment.

However, because of the risk of them developing into skin cancer actinic keratoses are usually removed.

Less often, actinic keratoses are removed for cosmetic reasons.

Referral may be made to a specialist for further assessment or treatment.

What are the treatments for solar (actinic) keratosis?

A number of treatments are available for solar (actinic) keratosis:

They include:

Cryotherapy. Liquid nitrogen ‘freezes’ the surface skin, which causes some skin redness until the area is replaced by new skin.

Surgical removal: The skin patch may be removed by scraping or curettage, or by cutting it out or excision biopsy.

Cream or gel. Topical treatments include Efudix cream (5- fluorouracil), Aldara cream ( imiquimod) or Solaraze gel ( diclofenac sodium).

Photodynamic therapy. A chemical is applied to the skin, then after several hours it is exposed to a light that activates the chemical to destroy the abnormal skin cells.

Preventing actinic keratoses or solar keratoses

To prevent actinic keratoses or solar keratoses, it's important to:

  • Avoid exposure to sunlight during peak sunlight hours (10 a.m. to 4 p.m.)
  • Wear clothing that covers arms and legs.
  • Wear a wide-brimmed hat (not just a cap) or carry an umbrella during peak sunlight hours.
  • Use sunscreen with sun protection factor (SPF) of 15 or higher, applying it at least 15 to 30 minutes before sun exposure, and re-applying regularly whilst outdoors.
  • Choose a sunscreen that provides both UVA and UVB protection.
  • Remember that it is the light from the sun that can be dangerous (not the heat) so you can be at risk even if the temperature is mild.
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on January 13, 2014

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