Actinic Keratosis
Solar Keratosis / Actinic Keratosis / Sunspots
  • commonly known as sunspots.
  • are rough, red, scaly, or crusty spots on the skin caused by excessive exposure to UV radiation in the past.
  • more common on sun-exposed areas, such as the face, nose, ears, chest, forearms, and back of the hands.
  • can feel rough like sand paper.
  • often easier to feel than to see.
Am I At Risk of Developing Solar Keratosis?

Can develop in anyone with frequent sun exposure, more common in people:

  • with fair complexion.
  • over 40 years old.
  • who have been outdoors for longer periods.
  • who have used solariums.
  • are immunosuppressed (eg. organ transplant patients).
Is Solar Keratosis 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.
How can I prevent my skin from getting Solar Keratosis?
  • UV protection will reduce development of new solar keratosis and worsening of existing ones.
  • Sunscreen has been proven to work in this area.
Warning Signs A Solar Keratosis Is Becoming Cancerous
  • Sometimes a solar keratosis will give clues, such as the spot becoming thicker and crusty, or becoming tender, especially when squeezed.
  • If you notice this change, please have it checked carefully by a qualified doctor to confirm the diagnosis. A biopsy may be required.
Treatment For Solar Keratosis

This generally depends on the number of lesions requiring treatment.

Under 10-20 lesions:

  • Cryotherapy – freezing with liquid nitrogen destroys the abnormal cells within the solar keratosis.
  • Curettage and Cautery (physical and electrical).
  • Topical Therapy (medication creams) over days to weeks.
  • Surgical Removal – generally for lesions that have turned into squamous cell carcinoma.

For multiple lesions or where lesions are affecting a large “field”:

  • Topical Therapy over days to weeks
  • 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.