Photo showing actinic keratosis on the face.
Actinic keratoses, also known as solar keratoses, are rough patches of skin caused by damage from years of sun exposure. They are not usually a serious problem and can go away on their own, but it's important to get them checked as there is a chance they might turn into skin cancer at some point.
Symptoms of actinic keratoses
Actinic keratoses usually appear on skin that is exposed to the sun.
Symptoms of actinic keratoses
Actinic keratoses usually appear on skin that's exposed to the sun. Common places to get them are the:
- face
- forearms
- hands
- scalp
- ears
- lower legs.
The patches can be:
- red, pink, brown or skin-coloured
- rough or scaly (like sandpaper)
- flat or stick out from the
skin (similar to warts)
- a few millimetres to a few centimetres across
- sore or itchy.
When to see your doctor/ GP
You must see your doctor/ GP if you have:
- an unusual growth on your skin that you're
worried about
- a patch or lump on your skin
that gets bigger quickly, starts to hurt or bleeds
- had actinic keratoses before and think you may
have a new patch.
It can be hard to tell if you have actinic keratoses. The patches can
look similar to other conditions such as warts or skin cancer. Your GP can usually check if it's actinic keratoses by looking at
your skin. They can refer you to a skin specialist if they are not sure.
Photo showing the characteristic skin changes of solar keratosis.
Treatments for actinic keratoses
Talk to your GP about the treatment options for actinic
keratoses. Sometimes they may just suggest that you check the patches
regularly and come back if they start to grow quickly, hurt or bleed.
If the patches cause problems (for example, they're unsightly or sore)
or your doctor is concerned they could turn into cancer, they may suggest
treatments such as:
- prescription creams and
gels – including 5-fluorouracil cream, imiquimod
cream, diclofenac gel (this isn't the same as the painkilling gel you
can buy) and ingenol mebutate gel
- freezing the patches (cryotherapy) –
this makes the patches turn into blisters and fall off after a
few weeks
- scraping away the patches
(curettage) with a sharp spoon-like instrument called a curette while
your skin is numbed with local anaesthetic
- photodynamic therapy (PDT) – where
special cream is applied to the patches and a light is shone onto them
to kill the unusual cells; this usually involves using a lamp,
but sometimes natural sunlight is used instead
- cutting out the patches with a scalpel
while your skin is numbed with local anaesthetic.
The best treatment depends on how many patches you have, where they are
and what they look like. Ask about the benefits and risks (such as side effects
or scarring) of each option.
Looking after your skin if you have actinic keratoses
If you have actinic keratoses, it's very important to protect your
skin from the sun. This can reduce the risk of more patches appearing
and may help reduce your risk of getting skin cancer. To protect yourself from the sun:
- cover your skin with clothes and a hat
during the summer months
- apply sunscreen with a sun protection
factor (SPF) of at least 15 before going out into the sun
- try to stay inside or in the
shade when the sun is at its strongest (between 11am and 3pm).
It may also help to use moisturising creams (emollients) on your
skin every day to stop it becoming dry.
Cancer risk and actinic keratoses
There's a small chance that actinic keratoses could eventually turn
into a type of skin cancer called squamous cell carcinoma (SCC) if they're not
treated. You are at a higher risk if you have lots of patches for a long
time.
Research suggests that people with several patches have around a 1
in 10 chance of getting skin cancer within 10 years of first developing actinic
keratoses. Signs that a patch has turned into cancer include it:
- growing quickly
- hurting
- bleeding.
Schematic diagram showing how actinic keratosis may eventually change into invasive squamous cell carcinoma (SCC), a common type of skin cancer.
You should see your GP if you have these symptoms or if you get any new patches or
lumps on your skin. SCC can usually be treated successfully if it's caught at
an early stage.
Source: NHS Choices