What should you know about pigmented solar keratosis?

The surface may feel sandpapery even when the colour is subtle. Pigment can make the lesion look like a sun spot or mole, so a clinician may use dermoscopy and, when the diagnosis is uncertain, a biopsy. Actinic keratoses are not the same as skin cancer, but a changing, thickening, tender, or bleeding lesion needs review because squamous cell carcinoma can look similar.

Arrange a skin examination rather than trying to remove the patch at home. Treatment depends on its thickness, number, location, and the appearance of the surrounding sun-damaged skin. Options may include freezing an individual lesion, a prescribed cream such as imiquimod or topical 5-fluorouracil, or photodynamic therapy for selected areas. Daily broad-spectrum sun protection, protective clothing, and shade help limit further ultraviolet injury.

Book a prompt dermatology review if the area grows, becomes raised, develops a firm base, repeatedly crusts, hurts, or bleeds. Seek earlier assessment for a new pigmented lesion that differs from nearby marks or changes over a short period. These features do not establish cancer, but they make examination and possible sampling more important.

Ask whether the lesion looks like actinic keratosis or another pigmented growth, whether dermoscopy or biopsy is appropriate, and which treatment fits its location. You can also ask how to care for the treated skin, when it should be checked again, and whether other sun-exposed areas need screening.