Actinic keratosis
Actinic keratosis, also called solar keratosis, describes dry rough patches of skin that develop where sunlight has been accumulating for years.
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Medicines commonly prescribed for Actinic keratosis
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: OINTMENT, 10 mg/gActive substance: tirbanibulinManufacturer: Almirall S.A.Prescription requiredDosage form: CREAM, 5 %Active substance: imiquimodManufacturer: Mibe Pharma Espana S.L.Prescription requiredDosage form: CREAM, 50 mg/gActive substance: imiquimodManufacturer: Industrial Farmaceutica Cantabria S.A.Prescription required
Actinic keratosis, also called solar keratosis, describes dry rough patches of skin that develop where sunlight has been accumulating for years. They are not dangerous in themselves, but they are more than a cosmetic blemish: a proportion of these lesions can in time turn into squamous cell skin cancer. That is why they are monitored and, where appropriate, treated.
What it looks like
- a dry, rasping patch that feels like sandpaper — often easier to find with a fingertip than with the eye;
- usually anywhere from a few millimetres to 2 cm across;
- colour varies from skin-toned to pink, reddish or brown;
- sometimes topped by a firm scale or crust that flakes off and forms again;
- it may itch, prickle or feel slightly sore when touched.
The patches appear on sun-exposed areas: the face, ears, forehead and balding scalp, neck, backs of the hands, forearms and lower legs. They are often multiple, and the skin around the visible patches is altered too, with patchy pigmentation and dilated vessels.
The risk is higher in people with fair skin that burns easily, in those who spent years working or relaxing outdoors, in sunbed users, and in anyone taking medication that suppresses the immune system — after an organ transplant, for instance.
When to see a clinician
- a new, persistent patch or scaly area has appeared;
- a lesion is growing, thickening, bleeding or becoming painful;
- a sore has not healed for several weeks;
- a lesion has appeared on the lip or eyelid;
- the patches are increasing in number.
On bleeding and thickening in particular: these are exactly the changes that separate a quiet keratosis from a lesion worth showing to a dermatologist without delay.
How it is diagnosed
A dermatologist's examination is generally enough, often with a dermatoscope — an instrument that magnifies the surface of the skin. If there is doubt between a keratosis and a skin cancer, a biopsy is taken: a small piece of tissue is sent for analysis.
Treatment
The method depends on how many lesions there are and where they sit.
- Cryotherapy. The lesion is frozen with liquid nitrogen; within days it crusts over and drops off. The most common approach for isolated patches.
- Prescription creams and gels. These are applied across the whole affected zone rather than to individual spots, which also clears lesions not yet visible. During treatment the skin becomes red and inflamed — that is the expected reaction.
- Photodynamic therapy. A light-sensitising preparation is applied and the area is illuminated at a specific wavelength. Convenient when there are many lesions on the face and scalp.
- Curettage or surgical excision. Under local anaesthetic; used for thicker lesions and when tissue is needed for analysis.
What is in your hands
Sun protection is not advice for the future but part of the treatment: it reduces new lesions and the likelihood that existing ones progress to skin cancer.
- SPF 30 or higher on exposed areas, reapplied every two hours and after swimming;
- a wide-brimmed hat and long sleeves;
- staying out of the sun in the middle of the day, when radiation is at its strongest;
- no sunbeds;
- checking your skin monthly and noting changes, with a dermatologist review once a year.
Common questions
Will every keratosis become cancer? No. Only a small proportion progresses, but there is no way to tell in advance which — hence treating them.
The patch went away by itself, do I still need treatment? Lesions can come and go. A review is still worthwhile.
Do over-the-counter creams help? Moisturising softens the scaling but does not remove the lesion. Treatment is prescribed by a clinician.
Online consultation
In an online appointment a doctor can review photographs of your lesions, point out which need a dermatologist's examination first, go through the treatment options and set up a sun protection routine. Removing lesions is done in person.
This article is for general information and does not replace a consultation with a doctor.
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Reviewed on Jul 3, 2026
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