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An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on your skin that develops from years of exposure to the sun. It’s most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck areas of skin typically exposed to the sun.
An actinic keratosis (AK) is a small, rough spot occurring on skin that develops because of chronic sun exposure. Actinic keratoses generally range in size between 2-6 mm in diameter (between the size of a pencil point and that of an eraser). They are usually reddish in color, with a rough texture and often have a white or yellowish scale on top. There is often a prickling pain felt when it is touched. Actinic keratosis often occurs against a background of sun damage, including sallowness, wrinkles, and superficial blood vessels. Actinic keratosis is also referred to as a solar keratosis.
An actinic keratosis, also known as solar keratosis, enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. An actinic keratosis takes years to develop, usually first appearing in older adults. Many doctors consider an actinic keratosis to be precancerous because it can develop into skin cancer.
Actinic keratosis facts
- An actinic keratosis is a small, rough spot occurring on skin that has been chronically exposed to the sun.
- Actinic keratosis is also known as a solar keratosis.
- Actinic keratoses occur most commonly in fair-skinned people after years of sun exposure.
- Common locations for actinic keratoses are the face, scalp, ears, back of the neck, upper chest, as well as the tops of the hands and forearms.
- Actinic keratoses are precancerous, which means they can develop into skin cancer.
- Doctors can usually diagnose an actinic keratosis just by examining it.
- The best treatment for an actinic keratoses is prevention by minimizing sun exposure.
- Treatments for actinic keratoses include cryosurgery, scraping or burning, 5-fluorouracil, imiquimod (Aldara), diclofenac (Voltaren, Cataflam, Voltaren-XR, Cambia), ingenol mebutate (Picato), TCA skin peels, and photodynamic therapy.
What are actinic keratoses?
Actinic keratoses are areas of sun-damaged skin found predominantly on sun-exposed parts of the body, particularly the backs of the hands and forearms, the face and ears, the scalp in balding men and the lower legs in women. They may also occur on the lips. The terms actinic and solar are from Greek and Latin, respectively, for ‘sunlight-induced’, and the term keratosis refers to thickened skin. They are usually harmless but there is a very small risk of some actinic keratoses progressing to a form of skin cancer called squamous cell carcinoma (see Patient Information Leaflet on Squamous Cell Carcinoma). Actinic keratoses are not contagious.
What causes actinic keratoses?
They are caused by excessive sun exposure over many years (from sunbathing, sunbed use, and outdoor work or recreational activities) and are therefore more common in older people. Fair-skinned, blue-eyed, red- or blonde-haired individuals, who burn easily in the sun but tan poorly, are at particular risk.
- No, but some of the factors that increase the risk of getting actinic keratoses such as a tendency to burn rather than tan, and freckling, do run in families.
What are the symptoms of actinic keratoses?
- They often cause little trouble. Many affected individuals are not aware of them at all. The affected skin feels rough and dry. However, if an actinic keratosis starts to grow into a lump, becomes itchy, tender or starts to bleed, medical advice should be sought as these changes could indicate the development of skin cancer (a squamous cell carcinoma).
What do actinic keratoses look like?
- Actinic keratoses can be variable in appearance, even differing from one another within a single individual. At first they can be hard to see, and are more easily felt, being rough, like sandpaper. They may grow to a centimetre or two in diameter. Some are skin coloured, others are pink, red or brown. They can become raised, hard and warty, and may even develop a small horny outgrowth. The surrounding skin often looks sun-damaged – blotchy, freckled and wrinkled.
How are actinic keratoses diagnosed?
- Usually the appearance of an actinic keratosis is sufficient to enable the diagnosis to be made, but in cases of doubt, for example if an early skin cancer is suspected, a sample (biopsy) or the whole affected area may be removed surgically under local anaesthetic for microscopic examination in the laboratory.
Can actinic keratoses be cured?
- Yes, but others may develop in the future from the surrounding sun-damaged skin.