Picato is a topical medicine commonly prescribed for the treatment of solar keratosis, also known as actinic keratosis. This treatment is developed and marketed by Leo pharmaceutical company and since it was first approved for use, it achieved remarkable success in renewing the skin that has been damaged by sun exposure.

Available in two levels of strength, Pitcato can be used to treat skin on the body as well as on the face and scalp. The 150 micrograms per gram version is prescribed to be applied to the face or head once daily over the course of three consecutive days, while 500 micrograms per gram version can be used on other body parts for two consecutive days.

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Actinic keratosis: A general overview

Solar keratosis is a skin condition that is caused by accumulation of minor injuries to the skin cells due to prolonged or repeated exposure to direct sunlight. The cells making up the skin are usually very efficient in preventing the damage caused by ultraviolet rays, but with persistent exposure, the very DNA of the cells can become damaged, making it more difficult to renew the affected area. In turn, this leads to the formation of dry and scaly patches of the skin – the tell-tale symptom of the condition.

The thickened skin usually appears red, pink or even brown with white or yellow crusty top in the most severe cases of solar keratosis. People with fair skin, blue eyes, freckles and red or blonde hair are more susceptible to sunburns in general, and the same goes for keratosis. However, the condition can take a long time to actually develop, sometimes even years, which means that is significantly more common in people aged 40 or above. At the same time, this doesn’t mean that younger people can’t get affected.

Who can get solar keratosis?

While the exact risk factors making people more susceptible to this condition are still debated in the medical community, the statistical research seems to show that men are more commonly diagnosed with this condition as opposed to women, and weakened immune system is also thought to play an important role. Working outdoors or using sunbeds have also been identified as contributing factors.

Preventing and treating actinic keratosis

The best and certainly most reliable way to prevent solar keratosis is by limiting sun exposure and ideally avoiding it altogether. As this is very rarely a real option, using sun protection of SPF 15 or higher should be used.

When it comes to treating and managing keratosis, it is worth mentioning that in some cases the patches will disappear on their own. However, in a vast majority of cases prescription treatment might be necessary in order to manage the condition. If left untreated, a fraction of keratosis cases will develop into a type of skin cancer called squamous cell carcinoma. Timely treatment will significantly reduce the chances of keratosis becoming cancerous.

Topical treatments such as Picato gel are the most common form of treatment for this condition. This kind of medicine can help mitigate the damage and facilitate the growth of healthy skin cells, thus significantly reducing the chances of any further complications. This medicine contains ingenol mebutate as an active ingredient, meaning its mechanism of action is closely tied to enhancing the skin’s natural immune system mechanisms and functions. If Picato topical treatment fails to achieve the desired results, further medical assessment is needed in order to prevent complications.

How to use Picato gel?

By precisely following the instructions provided by your doctor when using Picato gel, you will significantly reduce the chances of side effects manifesting. At the same time, proper use of this treatment will ensure the best possible results.

While detailed instructions can be found in the official patient information leaflet that is issued within every box of the medicine, here we will present you with just the most general guidelines so you can get the idea of how Picato treatment looks like.

  • Each new application should imply use of a new tube
  • Apply the contents of the tube to the affected area (in a 5cm by 5cm square) using your fingertip
  • After application, let the area dry for 15 minutes and do not touch nor wash it for the six following hours
  • Wash your hands with soap thoroughly after use – unless keratosis is present on your hands, of course – in that case, wash just your fingertips
  • Avoid using medication after showering or less than two years before going to bad
  • Leave the area free and uncovered

Are there any known Picato gel side effects?

As is the case with all prescription medications, Picato gel is also known to cause certain side effects in people susceptible. In a majority of cases, the area where the gel is applied will become red and develop scabs. However, this side effect will disappear within seven days.

When we take into account frequency of occurrence of different side effects, we can group them together in the following way:

Frequency of occurrence

Side effects

Very common (1 in 10 users or more)

Blisters, swelling, sores, redness or a burning sensation at the site of application

Common (1 in 10 users or less)

Skin infection, itching, irritation, headaches


Uncommon (1 in 100 users or less)

Numbness, ulcers and fluid discharge


These are just some of the documented side effects. For a full list, please refer to the official patient information leaflet.

Picato gel contraindications

When commencing Picato treatment, you should be aware of various contraindications. For example, this medicine might not be suitable for people currently taking some other drugs or supplements. In order to avoid any adverse drug interactions, you should inform your doctor about any other medicines you might be taking at the same time.

The same is true for various medical conditions, so be sure to use the consultations with a doctor to help him get an accurate view of your medical profile and history. Finally, this medicine might not be recommended for women who are currently breastfeeding or are pregnant.