You have a number of options for treating actinic keratoses, or age spots, at home. If you notice these spots, a dermatologist can prescribe the right medication for you.
Actinic (solar) keratoses are rough, scaly spots that usually appear on your hands, arms, or face. They’re sometimes also called age spots or sun spots.
They typically have a diameter of under an inch (or 2.5 centimeters) and may have a brown, red, or pink appearance. Sometimes, they may itch or bleed and crust over.
This skin condition happens as a result of years of skin damage due to sun exposure, which can cause irregular growth in skin cells called keratinocytes.
These spots aren’t cancerous themselves, but up to 10% of actinic keratoses can progress to squamous cell carcinoma (SCC), the second most common type of skin cancer.
For this reason, you’ll typically want to have a dermatologist check out your actinic keratoses.
Actinic keratoses sometimes heal on their own, but they usually need professional treatment. A number of different treatments can help address actinic keratosis. As part of your care plan, your dermatologist might prescribe medication for at-home treatment.
“There are no known nonprescription home remedies for treating actinic keratoses,” says Dr. Loretta Pratt, a board certified dermatologist based in Chadds Ford, Pennsylvania.
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But you do have several options for treating actinic keratoses at home with prescription medication, Pratt says.
These options are all topical treatments that you apply directly to your skin.
1. 5-fluorouracil
“One of the widely used and most effective prescription at-home therapies is topical chemotherapy called 5-fluorouracil,” Pratt says.
Brand names for this medication include Carac, Efudex, Fluoroplex, and Tolak.
Your dermatologist might suggest applying it once or twice a day for several weeks. Depending on the extent of your actinic keratosis, they may recommend applying it to the entire section of affected skin instead of the individual lesions themselves.
The treated areas will eventually become crusty and sore, Pratt says, and then you can use healing ointments like Aquaphor after stopping 5-fluorouracil for 7 to 10 days. Your doctor can offer more personalized guidance.
You may need to repeat the medication, depending on the severity of the actinic keratosis lesions, according to Pratt.
2. Diclofenac sodium
Diclofenac sodium gel (Solaraze, Cambia, Voltaren) is a topical nonsteroidal anti-inflammatory drug (NSAID) that can help treat actinic keratosis. It’s not clear why it helps reduce the appearance of skin lesions.
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You’ll also want to avoid exposing your skin to the sun while using diclofenac sodium gel. Along with wearing sunscreen every day — whether you go outside or not — you may also want to consider using hats, gloves, and other clothing that can cover or shield the affected area of skin.
3. Imiquimod
You may get a prescription for this medication if you have actinic keratoses on your face and scalp. This medication works by affecting your body’s immune response to skin lesions. In basic terms, it prompts your immune system to release cytokines, which can cause inflammation that helps destroy the actinic keratosis lesions.
When using this medication, you’ll experience a skin reaction, which might include itching, burning, and swelling. These signs mean the treatment is working.
If a doctor prescribes imiquimod, they’ll likely direct you to:
- apply it once daily two times per week
- leave the medication on your skin for 8 hours and then wash it off
- space out medication applications by 3 or 4 days
- keep applying it for 16 weeks, even if your keratoses go away before then
4. Ingenol mebutate
You’ll apply this medication gel once a day for 2 or 3 days in a row and leave it on for about 6 hours before washing it off. Your dermatologist will give you more specific, personalized directions on using this treatment.
5. Tirbanibulin ointment
This treatment is typically used on the face and scalp. Research from 2021 suggests it may cause fewer side effects than 5-fluorouracil, diclofenac, and imiquimod.
Generally, you’ll apply it directly to the affected skin once a day for 5 days in a row. Avoid applying it anywhere other than the areas your dermatologist told you to treat.
Self-care strategies can’t replace professional treatment from a dermatologist, but they may help keep actinic keratosis lesions from getting worse or coming back.
It may help to:
- limit your time in the sun
- apply sunscreen with a high SPF regularly
- wear sun-protective clothing
Pratt also notes that some studies suggest an antioxidant-rich diet may help prevent actinic keratosis.
Foods high in antioxidants include:
- berries
- spinach and kale
- beans
- dark chocolate
- pecans
In some cases, Pratt says, your dermatologist might suggest in-office treatments for your actinic keratosis.
In-office treatments can include:
- cauterization
- chemical peels
- cryotherapy, also called cryosurgery
- curettage
- excision
- laser resurfacing
If your dermatologist performs an in-office treatment, they can also offer more guidance on caring for your skin after the treatment. With some treatments, like chemical peels, you’ll want to take extra care to avoid sun exposure for a certain period of time.
Depending on the extent and location of your keratoses, your doctor might suggest a combination of at-home and in-office treatments.
Actinic keratosis can eventually develop into skin cancer. That’s what makes it so important to connect with a dermatologist if you believe you could have actinic keratosis.
Not only can a dermatologist help identify and treat this skin condition, but they can also screen for skin cancer. And when it comes to skin cancer, early detection can save your life.
“The American Academy of Dermatology recommends annual skin cancer screenings for all adults,” Pratt says, going on to emphasize the importance of adding this screening to your annual checkup.
“Skin cancers, including melanoma, can occur on any part of the body, even in non-sun-exposed areas, so overall, it is best to have a complete skin exam annually by a dermatologist.”
It’s always a good idea to reach out to a dermatologist if you notice any skin changes, including the development of:
- bumps
- flat lesions
- discolored patches of skin
- lesions with irregular borders or variations in color
- moles that change in size, color, or texture
- painful moles, bumps, or lesions
- rough, sandpaper-like areas
- sores or moles that bleed or scab
- scaly or crusty lesions
Growths or changes in the color and texture of your skin don’t necessarily mean you have skin cancer. Still, a dermatologist can help identify and treat any skin concerns and recommend next steps for cancerous or pre-cancerous growths.
If you’ve had actinic keratosis before, keep in mind that they can recur. So, it may be worth scheduling regular check-ups with a dermatologist as a preventive step.
Actinic keratosis is a skin condition caused by prolonged exposure to the sun. While no home remedies can treat this condition, a doctor might prescribe at-home topical medications to reduce its appearance.
You can lower your risk of developing actinic keratoses by reducing sun exposure and using sunscreen every day. If you notice any signs of actinic keratosis or other changes in your skin, a good next step involves making an appointment with a dermatologist to get a diagnosis and treatment as soon as possible.
Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.