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Ingenol mebutate

Picato gel is used to treat solar or actinic keratosis, a skin condition identified by scaly thickened patches caused by overexposure to the sun.

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PLEASE NOTE: This treatment is not available through our online pharmacy service. This page is for information only. If you are experiencing any of the symptoms related to the condition(s) this medication treats, we strongly recommend that you see your GP in person.

This content was reviewed by a clinician on

05 December 2019
dr daniel

Dr Daniel Atkinson

(GP Clinical Lead - GMC No. 4624794) 05 December 2019
Product information

Picato is a topical medicine prescribed to treat the skin condition known as solar or actinic keratosis. Picato gel has been manufactured by pharmacy brand Leo to help renew sun damaged skin cells. It is available in two strengths so that it can treat the skin on the body as well as the face and scalp. The 150 micrograms/gram gel is used once daily for three consecutive days to treat the face and scalp; whereas the 500 micrograms/gram gel can be used on the body, arms, hands and legs once daily for two consecutive days.

  1. Two or three day course 
  2. Easily applied gel
  3. Restores healthy skin cells

Solar keratosis occurs due to minor but repeated sun damage. The cells which make up our skin are usually adept at dealing with the ultraviolet rays given off by the sun. However, over time these cells can become damaged making it more difficult for it to repair overexposed areas. This can lead to the formation of dry and scaly patches on the skin known as solar keratosis. The thickened skin can appear red, pink or brown with a white or yellow crusty top. People with fair skin, blue eyes, freckles, red hair and a tendency to burn easily when exposed to the sun’s rays are most likely to develop patches of keratosis. The condition can take years to develop which means that it is more often found in people over the age of 40 but younger people can be affected too. Men are more commonly diagnosed than women. You are more likely to be found to have actinic keratosis if you use sunbeds, work outdoors or have a weakened immune system.

The best way to prevent solar keratosis from forming is by limiting all sun exposure. If being exposed to the sun is unavoidable then sun protection of SPF 15 or higher should be used.

Keratosis patches can sometimes resolve on their own. However, the majority will remain present on the skin and, if left untreated, there is a small chance that they might develop into skin cancer, known as squamous cell carcinoma. Early treatment can reduce the possibility of the keratosis becoming cancerous. Topical treatment such as Picato gel may be prescribed to help repair the damaged skin. The product contains the active ingredient ingenol mebutate which is thought to encourage the skin’s natural immune system. If Picato topical treatment does not resolve the symptoms then further medical assessment is advised.

Please note that this medication is not available to buy from our site. We recommend that you make an appointment with your GP if you are seeking treatment for keratosis.

Page last reviewed:  05/12/2019


Adhering to the instructions provided by your doctor when using Picato should help reduce the likelihood of side effects and encourage the best results from the treatment.

  1. For each application a new tube should be used. 
  2. Apply the contents of one tube to the affected area (5cm x 5cm) using your fingertip.
  3. Following application let the area dry for 15 minutes and do not touch or wash it for six hours.
  4. Wash your hands with soap and water immediately after use. If you are treating your hands, you should only wash your fingertips. 
  5. Avoid using this medication immediately after a shower or less than two hours before going to bed. 
  6. Leave the area free from bandages.

Full instructions can be found in the patient information leaflet.

Download Picato 150mcg/g patient information leaflet

Download Picato 500mcg/g patient information leaflet


Page last reviewed:  05/12/2019
Please read the patient information leaflet for this medicine fully before use:

Picato 150 mcg

Picato 500 mcg

Side effects & Warnings

Side effects

It is likely that after using this product the treatment area may become red and develop scabs. This can usually last for up to one week after use, whilst the treatment is working, but improvement should be noted within four weeks.

All medicines can produce unwanted side effects. Not everyone will develop them but it is still important that you are fully aware of the potential reactions. Further medical attention may be required if a serious reaction is observed. You can read more about the potential side effects in the enclosed patient information guide.

Very Common (1 in 10 people or more):

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

Common (1 in 10 people or less):

Skin infection, itching, irritation, headaches.

Uncommon (1 in 100 people or less):

Numbness, ulcers and fluid discharge.

This list serves only as a brief overview of the potential side effects related to Picato. More information can be sought in the patient information leaflet.


Taking it with other medicines

When completing our online health assessment you should list any other treatment you are using or have recently used. This is so that our doctors can make an informed decision as to whether the product you have selected is safe for you to use.

Conditions to look out for

Let your doctor know about any medical conditions you have during consultation.

Pregnancy and breastfeeding

Ask your doctor for advice before using this treatment if you are pregnant, breastfeeding or trying to become pregnant.

Page last reviewed:  05/12/2019
Please read the patient information leaflet for this medicine fully before use:

Picato 150 mcg

Picato 500 mcg


Can I still drink alcohol?

There are no known interactions between Picato and alcohol. However, we would recommend limiting your intake, so that you can continue to administer the gel in the manner prescribed by your doctor.

Will I still be able to drive?

Picato does not affect your ability to drive.

Can I take the medicine while pregnant?

You should avoid use of Picato when pregnant.

How should I store it?

Keep the product out of sight and reach of children. Store in a refrigerator (2°C-8°C). Do not exceed the expiry date.

Am I allergic to anything in the medicine?

Do not use this product if you are allergic to ingenol mebutate, isopropyl alcohol, hydroxyethylcellulose, citric acid monohydrate, sodium citrate, benzyl alcohol, purified water.

Is it available over-the-counter?

No. You will require a prescription from a registered doctor in order to buy Picato.

Is it right for me?

Talk to your doctor. They will be able to help you find the most appropriate treatment after assessing your symptoms.

Please note that we do not sell this medication through our site.


Page last reviewed:  05/12/2019
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