Actinic Keratoses

Actinic keratoses, sometimes known as ‘solar keratoses’, are dry, scaly or rough patches of skin caused by damage from years of sun exposure.


Whilst most of the time these patches can resolve on their own, and they aren’t necessarily serious, they may be unsightly, causing self-consciousness, and they can be a precursor to more concerning conditions like skin cancer.

While actinic keratoses is not classed as a skin cancer, if the condition’s lesions are left untreated, there is a small risk that they can develop into squamous cell carcinomas (SCCs), so many patients choose to pursue treatment, taking the opportunity to treat lesions before they can develop into skin cancer.

Anyone who has actinic keratoses is best advised to be routinely assessed by a dermatologist in addition to self-monitoring and to limit their exposure to harmful UV rays.

Whilst most of the time these patches can resolve on their own, and they aren’t necessarily serious, they may be unsightly, causing self-consciousness, and they can be a precursor to more concerning conditions like skin cancer.

Symptoms of Actinic Keratoses

Actinic keratoses develops as a result of prolonged exposure to ultraviolet (UV) light, and most often presents in skin that has been regularly exposed to the sun’s rays – typically on the face, ears, hands, shoulders, upper chest and back.

However, the popularity of unhealthy exposure to UV light – whether sunbathing on holiday, or through the use of harmful tanning beds and sun lamps – means actinic keratoses may develop in other areas.

The symptoms of actinic keratoses can be quite varied, which can make them difficult to assess and monitor without the help of a dermatologist, particularly if patients have other skin issues such as eczema or psoriasis, as the condition may present similarly.

In some people, they may present as more sensitive areas of the skin, leading patients to say they are more easily felt than seen. The skin can often feel dry and rough to the touch; the area can be raw, sensitive and painful; and some patients describe the area as itchy, or as though they feel an intense ‘pricking’ or burning sensation. In others, the presentation of actinic keratoses is more obviously observed inflammation that can look and feel quite sore.

Very rarely, people with actinic keratoses bleed or develop a sore that will not go away even after several days - this is what’s known as an ulceration. In other cases, the presentation will come and go in the same spot without feeling sensitive or inflamed at all.

Actinic keratoses patches can present as:

  • red, pink, brown or almost perfectly match the skin tone
  • textured, rough, or scaly (like sandpaper)
  • flat or stick out from the skin (may look like warts)
  • thick skin
  • spiky or ‘hornlike’
  • relatively tiny, just few millimetres, to a few centimetres across
  • sore, itchy or inflamed

While on their own, actinic keratoses may not cause serious discomfort or otherwise impact an individual’s life, they should be seen as a warning sign, as they can be a precursor to skin cancer. People who are at increased risk of developing actinic keratoses and who have spent much time in the sun are advised to see a dermatologist in addition to self-checking.

Altering lifestyle habits in order to limit exposure to harmful UV rays is essential in everyone, however in patients presenting with actinic keratoses, the damage has been done and must be assessed so that the condition does not progress to anything more worrying.

Causes of Actinic Keratoses

Some eczema is caused by allergies, or contact with chemicals and certain metals, but there may be other causes – for example, genetic predisposition; problems with the immune system function; environmental factors; infections; skin dryness; or stress.

The primary cause of actinic keratoses is overexposure to ultraviolet (UV) light – either from the sun, or from harmful artificial tanning practices, such as sunbeds or sunlamps – usually over the course of multiple years or decades. Many patients with the condition are frustrated due to the historical lack of warning or information about sun exposure or the danger of sunbeds.

Although patients will likely to see the condition recur, there is help and support available, and they may reduce their susceptibility to further actinic keratoses and skin cancer by self-checking their skin for any changes, and being vigilant to stay out of the sun or any artificial tanning involving ultraviolet light. Sun awareness plays a key role in preventing skin cancer, and for patients with actinic keratoses it often means drastically changing their lifestyle habits: staying out of the sun (especially when the UV rays are at their most potent); staying in the shade; wearing a wide-brimmed hat and UV-blocking sunglasses outdoors; covering up exposed skin; and applying a broad-spectrum sunscreen to help block out harmful UV rays.

Treatment of Actinic Keratoses at Derma

Your appointment will begin with the dermatologist’s thorough assessment of your skin, and inspection of the actinic keratoses lesions.

Together with the dermatologist, you will discuss your medical history and lifestyle habits, in order to identify the key areas that will help you to avoid further risking the development of skin cancer. This will enable to build a plan of action for the future with the very best medical advice.

The dermatologist will explain all available treatments as well as their potential side-effects, in order to enable you to select the best option for you.

It’s possible to treat actinic keratoses with;

  • Surgery
  • Topical creams and ointments
  • Cryotherapy
  • Curettage (scraping performed by a dermatologist)
  • Laser 
  • Photodynamic therapy
  • Or a combination of the above treatments

It is important to note that not all patients are medically suitable for every treatment, and depending on what you prefer, further tests might be required to manage the treatment.

In patients with actinic keratoses, follow-up appointments are essential to monitor the condition and ensure the lesions do not develop into skin cancer; or if they do evolve into a skin cancer, that you are treated straight away.

Patients with actinic keratoses should undergo follow-up appointments and contact their GP or dermatologist should new lesions, or suspicious growths present.

We see and treat more skin cancer patients than any other doctors in Reading, so you can be assured that Derma will provide the very best care, the latest research and the most effective treatments.

Related Specialists at Derma

The following dermatologists specialise in Actinic Keratoses

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