Actinic keratoses (AKs, also known as solar keratoses) are common and usually harmless, but they do have the potential to become malignant. AKs commonly appear as multiple lesions that gradually enlarge. The presence of multiple lesions is described as ‘field cancerisation’ or ‘field change’. Over a one year period, 15-25 per cent of AKs will disappear spontaneously without any intervention. AKs are caused by frequent or intense exposure to UV radiation over many years, and so usually appear on sun-exposed skin areas including the face, ears, bald scalp, forearms and on the backs of hands.

Management of AKs

The uncertainty about which AKs will transform into SCCs makes prevention of AKs an important issue, especially for organ transplant patients, who are at greater risk. Education of patients regarding UV-protection, self-examination and detection of early lesions plays an important part in overall management.

Preventative measures for AK

Avoid over-exposure to UV light – limit the time spent in the sun, especially around midday

Use a high factor (SPF 50) sunscreen on all exposed skin, including lips, and cover skin when possible

Avoid tanning beds – tanning beds emit ultraviolet A (UVA) rays, which penetrate deeper into the skin and are believed to cause AK lesions

Check skin regularly and report any changes to a healthcare professional.