Recently started on methotrexate again and was surprised to read all the warnings in tge literature pack about light sensitivity and resulting cancers.
I already have actinic keratosis and what look BCC developing on my nose and forehead.
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I have AK on my lip from historic sun damage because I’m so fair - almost albino. Ironically, my SSc T spots and freckles have given me some quite welcome hyperpigmentation! I just wear hats and cake exposed areas in factor 50 all year round but especially from April to September. It hasn’t got worse from taking methotrexate for a few years nor Mycophenolate now. My dermatologist is a skin cancer specialist so I’m seen regularly in her immunosuppressant clinic and use Efudix cream about twice a year on the area on my lip. Just cover up as much as you can and get your AK and other areas regularly checked out by your GP or, better still, a dermatologist
I have been taking Methotrexate for 22 years and have o ly fairly recently seen this warning , also on Hydroxychloroquine. I did have bad reaction last year in Portugal for the first time and am now very careful, but no sign of any nasties but I do have a more sallow skin.
I've been on methotrexate for five years now (25mg weekly). I work outdoors so avoiding UV light would be difficult, I'm reasonably sensible about protecting my skin but I still get a bit of sunburn. So far, apart from some telangiectasias and broken veins not caused by methotrexate I've had no nasty skin problems, but then my skin is as tough as old boots after a lifetime of working outdoors.While all these warnings should not be ignored, they're also there to help cover the drug manufacturers if litigation occurs.
I would agree with OldTed60 in taking care and being sensible about it.
Best of luck.
Methotrexate side effects in saliva?
Sceroderma skin involvement on elbows?
Dry skin and systemic sclerosis 
Scleroderma and very dry skin
