Actinic Keratosis (AK)

Medically reviewed by The Dermatologists and written by Dr. Alexander Börve

Updated on March 15, 2024

Actinic keratoses (singular- actinic keratosiss) are red scaly spots on the skin caused by sun exposure and represent a precursor to squamous cell skin cancer.

The risk of actinic keratosis increases with age and is more common for people with lighter skin and hair, weak immune systems, or a history of intense sunburns are more susceptible to the condition. It is important to have a dermatologist treat your actinic keratoses because these can develop into squamous cell carcinoma if left untreated.

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Symptoms of Actinic Keratosis

Actinic keratoses are small red scaly spots, most often found on the scalp of balding men, the face, the ears, and anywhere else that is sun exposed. The scale can come and go. With time, scale can accumulate and the lesion can grow larger.

• Rough, Scaly Patches: Under 1 inch, varying in color from pink to brown.
• Texture: Flat to raised, sometimes wart-like.
• Sensations: Itching, burning, potentially bleeding or crusting.
• Common Locations: Scalp (especially in balding men), face, ears, neck, hands, and forearms.

Eventually, an actinic keratosis can develop into a squamous cell skin cancer which tend to be thicker red lesions with more scale.

What can I do?

Avoiding excessive exposure to the sun is the best way to prevent actinic keratosis.

You can wear a sun hat and clothing to protect your skin from sun. For the parts that cannot be protected with clothing, such as the face and hands, you can apply sunscreen with a good sun protection factor (SPF). You can consult a dermatologist to choose the best option for you.

To effectively prevent actinic keratoses, consider adopting these sun safety measures:

• Limit Sun Exposure: Particularly between 10 a.m. and 2 p.m., avoiding sunburn and tanning.
• Use Sunscreen: Apply a broad-spectrum SPF 30+ sunscreen on all exposed skin and lips, even on cloudy days, reapplying every two hours or after sweating or swimming.
• Infant Care: Keep babies under 6 months out of direct sunlight, using shade and protective clothing instead.
• Cover Up: Wear tightly woven clothing and broad-brimmed hats for added protection.
• Avoid Tanning Beds: The UV damage is comparable to sun exposure.
• Regular Skin Checks: Monitor for new or changing skin growths and consult a healthcare provider with any concerns.

It is important to have a dermatologist treat your actinic keratosis to prevent it from developing into squamous cell carcinoma.

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Should I seek medical care?

Because actinic keratosis can develop into skin cancer, you should treat it as soon as possible to reduce the risk of squamous cell carcinoma. Up to 10% of cases of actinic keratosis  lead to squamous cell carcinoma, so it is advised that you consult a dermatologist.

Treatment for Actinic Keratosis

Actinic keratoses may be treated in several ways. Topical creams can treat actinic keratosis before it becomes cancerous. Laser surgery, chemical peels, and cryotherapy are other options for removing the lesions.

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