What should you know about senile solar keratosis?

Actinic keratosis commonly feels rough, scaly, or sandpapery and may look pink, red, brown, or close to the surrounding skin. It often appears on sun-exposed areas such as the face, ears, scalp, forearms, and backs of the hands. A lesion can be easier to feel than see, and several can occur in one sun-damaged area.

Most rough spots are not cancer, but an actinic keratosis can occasionally develop into squamous cell carcinoma. A visual examination helps distinguish it from other causes of scale, and a sample may be needed when the diagnosis is uncertain or the lesion looks concerning.

Arrange a skin examination for a persistent rough spot, especially if it is growing, tender, thickening, or repeatedly crusts. Treatment depends on the number, thickness, location, and appearance of lesions. Options may include freezing an individual lesion, a prescribed cream for a wider area, or light-activated treatment. Do not scrape or burn a spot yourself. Use broad sun protection, clothing, shade, and regular checks of previously exposed skin.

Contact a dermatologist promptly if a spot bleeds without clear injury, becomes painful, forms a persistent sore, grows quickly, develops a firm raised centre, or changes noticeably. A sore that does not heal, or a lesion with increasing tenderness and discharge, needs assessment for possible skin cancer rather than repeated home treatment.

Ask whether the spot is an actinic keratosis, whether it needs sampling, which treatment fits its location, how to care for the treated area, and when the skin should be checked again.