Solar Keratosis: What Is It, What Causes It and How Can You Protect Your Skin?
Solar keratosis, also known as actinic keratosis (AK), is a common skin change caused by cumulative exposure to ultraviolet (UV) radiation from the sun. It usually appears as a dry, rough or scaly patch on areas of skin that receive regular sun exposure.
Although solar keratoses are not usually serious, they are important to recognise because a small number can develop into a type of skin cancer called squamous cell carcinoma (SCC).
What causes solar keratosis?
Solar keratosis develops because of long-term UV exposure. The damage can accumulate over many years, meaning a person may develop actinic keratoses even if they have not experienced frequent sunburn.
Common sources of UV exposure include:
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Everyday outdoor activities
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Working outdoors
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Sunbathing
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Holidays in sunny climates
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Using sunbeds or artificial UV tanning equipment
Solar keratoses are most commonly found on areas that receive a lot of sunlight, including the face, ears, scalp, backs of the hands, forearms and legs.
What does solar keratosis look and feel like?
An actinic keratosis can initially be difficult to see. Sometimes you notice it because of how the skin feels rather than how it looks.
It may feel:
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Rough or sandpaper-like
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Dry and scaly
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Slightly raised
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Itchy or sore
The patch can be skin-coloured, pink, red or brown and may gradually become thicker.
If you notice a rough patch that doesn't seem to go away, particularly on an area regularly exposed to the sun, it's worth having it assessed rather than assuming it's simply dry skin.
Is solar keratosis skin cancer?
No — solar keratosis itself is not skin cancer.
However, it represents sun-damaged skin and there is a small possibility that an actinic keratosis can progress to squamous cell carcinoma. The risk is greater in people with multiple or thicker lesions and certain other risk factors.
This is why monitoring your skin and seeking medical advice when a lesion changes is important.
When should you get a solar keratosis checked?
Speak to your GP or another appropriate healthcare professional if you notice a new or persistent lesion, particularly if it:
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Starts to bleed
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Becomes painful or tender
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Gets noticeably larger
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Changes colour
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Becomes thicker or develops into a lump
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Develops an ulcer or does not heal
These changes don't automatically mean that the lesion is cancerous, but they should be assessed.
How is solar keratosis treated?
Treatment depends on the number, thickness and location of the lesions and your individual circumstances.
Possible treatments include:
Cryotherapy: The affected area is frozen, causing the abnormal cells to die and the lesion to eventually disappear.
Prescription creams or gels: Treatments such as 5-fluorouracil or imiquimod can be prescribed for appropriate actinic keratoses. These treatments work on abnormal sun-damaged cells and can cause temporary redness, soreness and inflammation.
Photodynamic therapy: A light-sensitive treatment is applied to the affected area before a specific light source is used to destroy abnormal cells.
Surgical treatment: Some lesions may need to be removed or scraped away, particularly when there is concern about their appearance or diagnosis.
Your healthcare professional can recommend the most appropriate treatment.
Can you prevent solar keratosis?
You cannot undo previous UV damage, but you can reduce further exposure and help protect your skin from additional damage.
Good sun protection includes:
Use sunscreen
Use a broad-spectrum sunscreen with at least SPF 30, applying it generously and reapplying as recommended, particularly when spending prolonged periods outdoors.
Remember that sunscreen is only one part of sun protection.
Cover up
A hat, sunglasses and clothing that covers exposed skin can provide additional protection.
Seek shade
Try to avoid prolonged exposure when the sun is strongest and make use of shade where possible.
Avoid sunbeds
Sunbeds expose the skin to artificial UV radiation and can contribute to cumulative skin damage.
Don't forget your scalp
If you have thinning hair or a bald scalp, it is particularly important to remember that your scalp is exposed to UV radiation.
A hat and appropriate sunscreen can help protect exposed areas of the scalp from further sun damage.
Check your skin regularly
Getting to know your own skin can help you spot changes early.
Every few months, take a few minutes to look over areas that are commonly exposed to the sun. If you notice something new, changing or persistent, seek professional advice.
You don't need to diagnose a solar keratosis yourself. If you're unsure about a skin lesion, getting it checked is the safest approach.
The bottom line
Solar keratosis is a visible reminder of the cumulative effects of UV exposure. While most actinic keratoses are not dangerous, they should not simply be ignored.
Protect your skin, check it regularly and take persistent or changing lesions seriously.
At Vertex Health & Wellness, we believe good personal care starts with informed choices. Sun protection isn't just about preventing sunburn — it's about protecting your skin from the effects of cumulative UV exposure throughout life.
This article is for general education and does not replace an individual assessment by a qualified healthcare professional. If you have a new, changing, bleeding or painful skin lesion, seek medical advice.