Solar Keratosis

What is Solar Keratosis?

Solar keratosis, also known as actinic keratosis, is a precancerous skin condition caused by long-term sun exposure. It appears as rough, scaly patches on sun-exposed areas such as the face, ears, scalp, hands, and forearms. While not all lesions become cancerous, they can progress to squamous cell carcinoma, making early diagnosis and treatment important.

Causes

• Chronic sun exposure (UV radiation)
• Tanning beds use
• Fair skin types (low melanin protection)
• Ageing – cumulative sun damage over decades
• Weakened immune system (e.g., transplant patients)
• Genetic predisposition

Symptoms / Appearance

• Rough, dry, scaly patches on the skin
• Pink, red, or brown lesions that may feel like sandpaper
• Flat or slightly raised spots, sometimes tender to touch
• May itch, burn, or feel sensitive
• Most often appear on sun-exposed areas (face, lips, scalp, ears, hands, forearms)
• Can be single or multiple patches

Treatments

Professional Treatments

• Cryotherapy – liquid nitrogen freezes and destroys the lesion
• Topical treatments:
  5-fluorouracil (Efudix)
• Imiquimod (Aldara)
• Diclofenac gel
• Ingenol mebutate
• Photodynamic therapy (PDT) – light-activated treatment that destroys abnormal cells
• Chemical peels – remove superficial damaged skin layers
• Laser resurfacing – removes and smooths damaged skin
• Surgical excision or curettage – for suspicious or resistant lesions

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At-Home Care (Supportive)

• Moisturisers to soothe dryness and irritation
• Strict sun protection to prevent further damage
• Regular self-checks for new or changing lesions

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Prevention

• Daily broad-spectrum sunscreen (SPF 30+)
• Wear protective clothing, hats, and sunglasses outdoors
• Avoid peak sun hours (10am–4pm)
• Stop using tanning beds
• Regular dermatology check-ups if at risk (fair skin, history of AKs, or skin cancer)
• Maintain healthy skin with hydration and antioxidants

FAQs

Q1. Is solar keratosis cancer?
No, but it is precancerous. If untreated, some lesions can develop into squamous cell carcinoma.

Q2. Can solar keratosis go away on its own?
Sometimes lesions may fade, but they often return. Medical treatment is recommended to reduce cancer risk.

Q3. How serious is it?
Most lesions remain harmless, but because of the potential for progression, monitoring and treatment are important.

Q4. Who is most at risk?
People with fair skin, light hair/eyes, history of sunburns, outdoor workers, and older adults.

Q5. Can I prevent new lesions after treatment?
Yes – with consistent sun protection and skin monitoring, you can reduce recurrence.