Treatment options for solar keratoses

Find the treatment that’s best for you

Assessment

Solar keratoses a precursor to non-melanoma skin cancer and it is impossible to predict which solar keratoses lesions will become cancerous. Even though relatively few solar keratoses lesions progress into non-melanoma skin cancer, specialists recommend that all cases of solar keratoses be treated. Your doctor can assess whether you have solar keratoses, and if necessary, discuss your different treatment options.

All treatments for solar keratoses work by killing the affected skin cells, allowing new, healthy cells to replace them from deeper layers of the skin.

Treating the lesion or the field

Lesion-directed treatment

For cases of few or isolated lesions, procedures that freeze or surgically remove the specific lesions are often used. This is also known as lesion-directed treatment, which focus on removing the visible lesions.  

These treatments include: 
• Cryotherapy, which freezes the affected skin
• Curettage, which involves scraping the skin with a sharp instrument
• Cautery, which burns the solar keratoses off and prevents bleeding
• Excision, which involves cutting the solar keratoses out of the skin

Field treatment

On areas of the skin with more solar damage having multiple solar keratoses lesions including non-visible solar keratoses lesions a so-called field treatment is often used. Field treatments target the entire sun-damaged skin area. Non-visible solar keratoses can occur up to 10-times more often than visible solar keratoses, particularly in long term sun-exposed skin. 

Field treatments include: 

• Topical treatments (creams, ointments, gels)
• Photodynamic therapy, which uses a chemical substance and a strong source of light to destroy the sun-damaged skin cells. 
You can read more about the different kinds of topical treatments in the article ‘More on topical treatments for solar keratoses’.

Deciding on the right treatment for you

It’s a good idea to know the different treatment options in advance of your discussion with your doctor about which treatment is best for you. Don’t be afraid to ask your doctor as many questions as you need to. 

Questions to consider

If your doctor prescribes a topical treatment, it may be helpful to make a list of questions to ensure you know how to use it correctly. These questions may include:

• How should I apply my treatment?
• How often should I apply my treatment?
• For how long should I apply my treatment?
• How does it work?
• How soon might I see results?
• What are the possible side effects of my treatment? 
• How likely is the risk of long-term cosmetic effects?
• Can I combine this treatment with another medication?
• Can I go out in the sun after applying this treatment?