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Can You Scratch Off Actinic Keratosis?

What is actinic keratosis?

Actinic keratosis, also known as solar keratosis, is a kind of skin damage that occurs after prolonged exposure to sunshine or UV light, such as working outside without proper sun protection, sunbathing or using tanning beds. 

An actinic keratosis lesion looks and feels differently from surrounding skin: it can be discoloured (red, pink, gey, brown, tan or silvery), slightly raised, feel gritty or like sandpaper, and it may be more sensitive, itchy or painful. Sufferers can get just one lesion, which might range in size from a tiny bump or nodule to a patch about an inch in diameter, or several across an area of skin.

Who’s most at risk from actinic keratosis?

Although actinic keratosis is a relatively common condition in later life, some people are more likely to develop it than others. At risk groups include people over 40 (sun damage is cumulative and happens over many years); fair-skinned people; those with thinning hair or bald scalps; people who’ve spent a lot of time outdoors over a lifetime; frequent sunbed users or sunbathers; people living in hot, bright countries, and those with compromised immune systems.

What happens if you leave actinic keratosis?

Although most actinic keratosis isn’t serious, and might appear to be just an irritating cosmetic issue, somewhere between 5-10% of cases develop into skin cancer. In fact, any actinic keratosis is termed ‘pre-cancerous’ sun damage, and needs to be checked out by a professional.

That said, an actinic keratosis may well develop after sun damage, and then go away on its own, without being treated or developing into cancer. It’s quite likely that a patch of damaged skin will heal and then recur, with the lesion persisting for years, especially after further or prolonged sun exposure to the same area.

What happens if you scratch actinic keratosis off?

It might be tempting to just pick off an actinic keratosis, but unfortunately it’s not a very effective way of getting rid of them, and can end up leaving you vulnerable to further damage. If you’re picking with your fingernails you are risking getting germs from under your nails into the skin and getting an infection, for example.

And unfortunately, however much you pick at actinic keratosis, it’s likely to recur unless it’s treated professionally.

The problem is that the damage done to the skin by sun exposure is not cosmetic; it runs deeper than the epidermis. It’s also important to remember that actinic keratosis is counted as precancerous damage, so needs to be checked out by an expert, and treated as necessary.

How is actinic keratosis treated?

Treatment for actinic keratosis can be divided into three different strategies, which can also be used in combination: 

  1. Surgery
  2. Phototherapy
  3. Topical medication

The surgery component covers quite a few different ways of actually removing the lesions from surrounding skin, and are likely to be safer and more effective than picking at it yourself!

Techniques for excising the lesion include:

  • Cryosurgery, which uses liquid nitrogen to freeze the skin so that it eventually falls off
  • Chemical peels, involving using chemicals to kill off the top layers of skin so that healthy skin regrows
  • Laser surgery, using a laser beam to vapourise the affected skin
  • Curettage & desiccation: using a scalpel or similar tool to scrape off the actinic keratosis, then using heat or topical medication on the scraped area

These are all more effective ways of getting rid of actinic keratosis than trying to remove it yourself. See our article What Is The Best Treatment For Actinic Keratosis? for more details about preventing and treating actinic keratosis.

Although actinic keratosis isn’t something you can treat with emollients, moisturising your skin with intensive, non-irritant creams or salves can help keep skin in good, healthy condition before and after treatment. We advise customers not to apply oil-based balms like Skin Salvation to skin exposed to direct sunlight, as the high oil content can cause burning and we don’t add sunscreens to our products. Apply last thing at night instead!

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Balmonds Daily Moisturising Cream
with shea butter and calendula

If you require medical advice we recommend you always contact your healthcare professional.

If you or someone you are caring for seems very unwell, is getting worse or you think there's something seriously wrong, call for emergency services straight away. For general medical advice, please contact your healthcare professional, this article does not contain or replace medical advice.

Do not delay getting help if you're worried. Trust your instincts.

Posted on: Feb 21, 2021

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