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Actinic Keratosis (solar keratosis)
















What is actinic keratosis?

Actinic keratosis, also known as solar keratosis, is a very common skin condition that usually presents in people over 50 or 60 years old. It is pre-malignant, meaning that if left for long enough, actinic keratosis can turn into a form of skin cancer - known as squamous cell carcinoma


What causes actinic keratosis?

They are also called solar keratosis, as they are caused by solar radiation (sunlight), and essentially represent very sun-damaged skin. This can be due to spending long periods in the sun, or simply having skin that is sensitive to sunlight


What does actinic keratosis look like?

Typically these present as small (1-2mm), flat, red, scaly areas. Often, more than one can be found and they are usually on sun-exposed areas such as the forehead. They are often mistaken as 'patches of dry skin'.

To see pictures of Actinic Keratosis, please click here


Why does Actinic Keratosis need treating?

Actinic keratosis in itself is not cancerous. They need treating, though, as in 5-20% of patients they can turn into squamous cell carcinoma, which is a potentially dangerous type of skin cancer. There is no way of telling which ones will turn into cancers.


How is solar keratosis treated?

There are a number of possible treatments, including:

  • Skin cream - there are a number of creams that can be applied regularly to the affected areas, resulting in the top layer of skin being 'burnt off', together with the keratosis. New creams stimulate the bodys' immune system to fight off the growths, and seem very promising in their effectiveness.

  • Cryotherapy - the solar keratosis can be frozen with a cold spray. This then blisters and falls off, leaving normal skin.

  • Curettage - under local anaesthetic, the growth can be 'scraped away', with minimal scarring

  • Chemical peel - this is usually used in the cosmetic setting, where the skin has a dilute acid applied to it. This takes away the very top layer of skin, leaving youthful skin behind. As actinic keratosis lies on the top layer of skin, a peel will remove them as part of the process. This is quite useful for large areas of sun-damaged skin.

  • Laser - this can again be used to remove the top layer of skin, taking the actinic keratosis with it. Laser can, however, sometimes also remove the skin pigment, leaving a permanently pale area.

  • Surgery - if a solar keratosis is resistant to other forms of treatment, then surgery may be needed to finally remove it. This can often be performed under local anaesthetic.



What happens after treatment?

Once the solar keratosis has gone, the specialist may want to keep a check on you to watch for any new growths occurring. Having had one growth, your skin has obviously been sun-damaged and so is prone to forming more in the future.



What are the overall risks to life?

If the solar keratosis has not changed into a squamous cell carcinoma, then there are no direct increased risks to life



How can solar keratosis be avoided?

Whilst the risks can never be zero, you can reduce your risks greatly with some simple steps. If you have had one keratosis, these steps may also reduce your chances of developing more growths:

  • Stay out of the sun, especially between 11am and 3pm, when it is most strong

  • Wear high factor sun cream if you need to go out in the sun (eg sports)

  • Reapply sun cream regularly and especially after swimming

  • Wear sun-protective clothing such as long-sleeved shirts and hats

  • Never get sunburnt, and keep children out of the sun


To see pictures of Actinic keratosis, please click here


Other SurgeryWise articles

You may also be interested to read our articles on basal cell carcinoma, melanoma, squamous cell carcinoma or moles.



The information provided is as a guide only and you should discuss matters fully with your specialist before deciding on the right procedure for you. If you have any concerns about a skin growth, seek medical advice immediately. Please also read our disclaimer



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