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Actinic keratoses (AKs) are common pink, red or brown scaly lesions of the skin caused by exposure to sunlight. About 10 per cent of AKs transform into skin cancers but at present there is no way of predicting which ones are more likely to transform. It is estimated that 60-80 per cent of squamous cell carcinomas (SCCs) started as AKs.

Immuno-suppressed people are 250 times more likely to develop AKs and 100 times more likely to develop SCCs than non-immuno-suppressed people, so photo-protection is an important measure for this group.

A recent two-year, randomised controlled trial in transplant patients comparing sun protection advice plus a photoprotection product (treatment) with advice alone (control) showed that the number of AKs decreased and there were no new SCCs in the treatment group, whereas in the control group the number of AKs and SCCs increased (Ulrich et al, BJD 2009).

The product used in the trial was Actinica – a photoprotection product containing a mixture of chemical filters with an estimated SPF of more than 60 (for UVB). It also provides good UVA protection. Actinica is licensed as a medical device so it can be supplied through community pharmacies.

Fiona Loud, policy director of the British Kidney Disease Patients’ Association, said transplant patients needed honest, balanced information about the risks and photoprotection measures, and regular, twice-yearly skin examinations. Front-line staff can help by finding out what skin services the local transplant unit offers and reinforcing patient education in this area, she said.