Solar Keratosis

What are solar keratosis?

These appear as scaly rough patches of skin that may itch and irritate. They are most frequently found on areas of skin that experience high levels of sun exposure. This includes the forehead, nose, cheeks,  upper lip, temples and back of the hands. Fair-skinned persons are most at risk and especially those that have lived abroad or worked outdoors. The surrounding skin may show other signs of sun-damage including brown sun-spots (solar lentigines), wrinkles (rhytides), and skin-thinning. Many people develop multiple solar keratosis on the face or scalp. Approximately 15-20% of the population aged over 65 years are expected to develop solar keratosis in the next few years.

Pictures

solar keratoses face
solar keratosis left temple
solar keratoses hands

severe actinic damage lower lip
solar keratosis left temple
actinic damage dorsum foot

Why are the important?

Solar keratosis affect people by making the skin itch and scale .There is also a small risk of skin cancer (1 in 200 lesions may develop into a skin cancer called squamous cell carcinoma).

What causes solar keratosis to develop?

Ultraviolet light damages the bottom layer of skin cells called the basal layer. This layer of skin is responsible for growth of the surface skin cells and damage to the cell structure in the basal layer makes these skin cells grow abnormally. This results in excessive growth of the cells producing the rough scaly skin and damage to the cell structure (DNA) increases the risk of skin cancer. Treatments generally destroy any abnormal cells that are present in the basal layer of the skin.

Is treatment necessary?

Up to 25% of solar keratosis may resolve without any action and treatment is only necessary if they cause symptoms or cosmetic embarrassment. The daily application of a moisturiser may help to reduce the symptoms of itch, irritation and roughness of the skin.

Treatment of solar keratoses

What can I do to help my skin problem?

Studies of individuals in Australia have shown that avoidance of further sun-exposure and regular application of sun-screens can help reduce the number of new solar keratosis developing. It is therefore important to protect your skin from the sun by wearing a wide-brimmed hat and using sunscreens with a Sun Protection Factor (SPF) of greater than 20, ideally 25-30. Daily application of a moisturiser to the skin may help and many daily moisturisers now contain sunscreens.