Solar Keratoses (sunspots): Signs, Symptoms, Management

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In Australia, the sun is much beloved. Our beaches are treasured, our beautiful weather heralded across the globe, and our skies are often clear and blue. The sun has many inherent benefits, including promoting a positive mood and helping to produce valuable Vitamin D in our bodies. But without the proper precautions, exposure to the sun can present a significant hazard to inhabitants of this nation.

In Australia, skin cancer is the most common type of cancer. Fortunately, it is possible to take steps to protect your skin from the ravages of the sun’s harmful UV rays. As well, it is vital to check your skin regularly for signs of damage. One common effect of long-term exposure to the sun is the appearance of sunspots, scientifically referred to as solar (actinic) keratoses. Sunspots are premalignant skin lesions have the potential to develop into cancer over time.

Confusingly some people call freckles and other pigment spots on the skin sunspots but these are entirely different.

Today, let’s take a closer look at sunspots and how to manage them.

Identifying Sunspots

Sunspots appear as small, hardened, and scaly growths on the skin. Commonly found on the head and neck, chest, forearm and hands, sunspots develop in areas of extended sun exposure. They feel rough and dry to the touch, and may be grey, pink or red in colour. The skin on a sunspot is dry and usually raised, and while generally they are not painful, they may itch or sting when irritated by sun exposure or scratching. Rarely, sunspots can bleed as well. Sunspots sometimes appear in small clusters. This may indicate a higher incidence of cancer potential.

Adults over the age of 50 are at the greatest risk for developing sunspots on their skin. At any age, however, it is wise to regularly inspect your body carefully for signs of sun damage. It is especially important to take note of any spots that are different from others around them, and to note lesions that have appeared suddenly or have changed over time.

Diagnosing & Managing Sunspots

Your GP may identify and treat sunspots. Dermatologists are trained experts in the management of sunspots and skin cancers. Biopsy is sometimes necessary to exclude actual cancer. Sunspots are common, and their appearance on your skin is not necessarily a cause for alarm. The majority of sunspots never develop into cancer, and especially when treated early, these lesions can be treated effectively. When left untreated, a small proportion of sunspots may progress into squamous cell carcinoma which has the potential to spread throughout the body (metastasis).

Your dermatologist will advise on the best course of action if you have sunspots on your skin. Treatment varies depending on the site, number and severity of the lesions and individual factors.

Treatments

One of the most common treatments for sunspots is the use of cryotherapy (freezing) with liquid nitrogen. This is administered by your dermatologist and the sunspot is eradicated and falls off within a few days. A short (2-5 second) freeze can successfully remove the majority of sunspots. Some thicker lesions require curettage and diathermy under local anaesthetic.
Where there are larger numbers of sunspots your dermatologist may prescribe a field treatment with a topical preparation. The most common is 5 fluorouracil cream. Others include imiquimod and diclofenac. These are applied over a few weeks or longer and gradually destroy the abnormal skin cells in the sunspot.
Your Dermatologist is a registered specialist who is best able to advise you on management of sun damage, skin lesions and skin cancer.