Actinic Keratoses: causes and treatments

Have you noticed crusty spots on your skin? Actinic keratoses (also known as solar keratoses) are areas of skin that have been damaged by the sun. They are patches of thicker, sometimes scaly skin that often appear on the backs of your hands and arms, face, ears, and, on the scalp of bald men and on women’s lower legs.

This condition is often harmless, however you do need to keep an eye on these patches. If one or more grows, is itchy, feels tender or bleeds, there is a chance that they could be developing into a squamous cell carcinoma, a type of skin cancer. Check your skin regularly, and if you do notice any changes, see your GP.

Actinic keratosis symptoms

The symptoms of actinic keratosis are rough, scaly skin patches on parts of the body exposed to the sun, such as arms, face, backs of hand, or the scalp on a bald man and the lower limbs of people who wear shorts or skirts.

These rough patches vary. They can be pink, red or brown or the same colour as your skin. They may be like sandpaper to touch, and may be hard and rather warty, or raised up from the surrounding skin. If you have any of the following it's possible you have actinic keratosis:

• Dry, scaly patches on skin
• Crusty spots on skin
• White, flaky bumps on skin
• Hardy dry spots on skin 
• Itchy patches on the skin
• A hard wart-like patch on the skin

Who gets actinic keratosis?

Actinic keratosis is most common in people over 40. It takes years of sun exposure, so anyone with an outdoor job is at more risk, as are people with a fair complexion.

How to protect against actinic keratoses

Protect your skin from the sun in the same way you would normally. Avoid going out in the hottest parts of the day. Wear hats and clothes that cover your arms and legs when out in the sun, and use sunscreen with a protection factor of 30 or more on yourself and your family.

Treatments for actinic keratoses

If this condition is bothering you, or your GP feels that it would be a good idea to remove the actinic keratoses, they may offer you a number of treatments.

• Creams may be a good option if you have a lot of actinic keratoses. They may, however make the skin being treated inflamed for a while.
• Photodynamic therapy involves putting a light-activated cream on the affected area, then activating it by shining a special light on it.
• Your GP may also suggest cryotherapy – freezing the area with liquid nitrogen, scraping off the affected skin (after injecting the area with local anaesthetic), or using laser treatment.

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