Solar Keratosis/Actinic Keratosis (sunspots)

Solar keratosis or actinic keratosis (also commonly known as sunspots) are rough, red, scaly, or crusty spots on the skin that are caused by excessive exposure to Ultraviolet Radiation (UVR) from the sun. They are more common on sun-exposed areas, such as the face, nose, ears, chest, forearms, and back of the hands.

Solar keratosis can feel rough like sandpaper, and may sometimes be easier to feel than to see.

Am I at risk of developing Solar Keratosis?

Anyone who has had frequent sun exposure can develop solar keratosis, but they are more common in people who:

  • have fair complexion (although they also occur in people with olive skin)
  • over 40 years old
  • have been outdoors for longer periods.
  • have used solariums
  • are organ transplant patients
Are Solar Keratoses Dangerous?

Solar keratoses are pre-cancerous (pre-malignant), which means they have a potential to turn into skin cancers called squamous cell carcinomas.

Squamous cell carcinoma if left untreated can spread internally to the lymph nodes and other organs, requiring more extensive surgery and/or radiotherapy. Squamous cell carcinomas can be fatal in some cases.

The exact risk of a solar keratosis turning into a skin cancer is not known. The rate is thought to be around 5-20%, although some experts believe it may be even higher than this. It is also not possible to predict which solar keratosis will eventually become cancerous.

Are there warning signs that the solar keratosis is becoming cancerous?

Yes. Sometimes a solar keratosis will give clues, such as the spot becoming thicker and crusty quite quickly, or becoming tender, especially when squeezed.

If you have noticed this change, please have it checked carefully by a qualified doctor as soon as possible. The doctor can confirm the diagnosis by taking a biopsy of the suspected keratosis.

Treatment for Solar Keratosis:

Solar keratosis can be treated many ways:

Cryotherapy – freezing with liquid nitrogen destroys the abnormal cells within the solar keratosis.

Curettage and/or Cautery (burning)

Topical Therapy (Creams):

Surgical Removal – generally indicated for borderline lesions where they may already have become squamous cell carcinomas

Photodynamic therapy – this is very useful for large areas and is performed in one day

If the solar keratosis persists despite the above treatments, it is important to check the spot for cancerous transformation.

How can I prevent my skin from getting solar Keratosis?

The best way to prevent new solar keratosis and worsening of existing sunspots is to reduce sun exposure. This can be done by:

Sun Avoidance
  • Try to avoid sun exposure during the middle of the day (between 10am – 3pm in summer)
Sun Protection
  • Seek Shade where possible
  • Wear Protective Clothing:
  1. Broad Brimmed Hats (preferably choose hats that protect the face, ears and neck)
  2. Wear long trousers and long sleeve clothing if possible
  3. Wear Sunglasses
  • Apply sunscreen to exposed areas of your skin:
  1. Try to apply the sunscreen at least 20 minutes before sun exposure
  2. Choose 30+ SPF sunscreens
  3. Remember to reapply after 2-3 hours and immediately after coming out of the water