What is it?
Changes to the skin caused by sun exposure. This can result in dry, red, scaly patches known as solar keratosis. It can also cause actinic keratosis - the harmless, warty spots that sometimes appear as we get older.
Who gets it?
It’s most common among fair-skinned people, especially those with blue eyes, red hair, freckles and a tendency to burn in the sun. Men are affected more than women, so are people who have lived abroad, worked outdoors, take frequent holidays or take part in outdoor hobbies. It takes years to develop and seldom appears before the age of 40.
What causes it?
The ultraviolet rays from the sun on our skin. It occurs when a skin cell’s control centre, the DNA, has been damaged by UV rays. The effects of the sun accumulate from the day we are born, and don’t happen overnight. The effects of tanning as a child, teenager or 20-something can show up several decades later. People who live in the UK are just as prone to sun damage as people living in Australia as we are exposed to enough UV rays to cause damage.
What are the symptoms?
You might notice freckles (lentigenes), large, isolated freckles (lentigos) and wrinkles. Patches of actinic keratosis can look reddish or brown, a bit like eczema, and skin feels rough and sometimes sore. Solar keratosis is extremely common. Spots are found on areas that are exposed to the sun, such as the face, forearms and hands, rims of the ears and bald scalps, and on the lower legs. These harmless spots appear without warning, and vary in appearance: they can be flat or raised, size varies from one millimetre to several centimetres in diameter, and they can be skin coloured, dark brown or pink, or a mixture. The texture can be smooth, rough or waxy. They often appear in crops, especially under the breasts, or on their own on the face or scalp.
What’s the best treatment?
It’s important to actinic keratosis patches checked by a GP or dermatologist as, very occasionally, they can develop into skin cancers called squamous cell carcinomas. Sun damage on its own is usually harmless, but tends to be permanent and persistent. If the patches or spots are sore or unsightly, creams are available on prescription that can destroy the damaged layers of skin, or they can be scraped or frozen off under local anaesthetic.