Actinic Keratosis

Actinic keratosis, also called solar keratosis or senile keratosis, is characterized by thick, scaly or crusty patches or lesions on the skin.

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What is Actinic Keratosis?

Actinic keratosis, also called solar keratosis or senile keratosis, is characterized by thick, scaly or crusty patches or lesions on the skin, usually on areas that receive excessive sun exposure, such as the face, ears, neck, lips, forearms and the back of the hands. It is considered a precancerous skin condition.

Actinic keratoses develop in range reaching to a quarter of an inch and may even disappear for a time. Their colors include red (most common), light or dark tan, pink or skin colored. Actinic keratoses may itch and may become inflamed and red and may even bleed.

Actinic keratosis (AK), also known as solar keratosis, is a skin disorder that causes rough, scaly patches of skin. Actinic keratosis forms on skin damaged by chronic exposure to ultraviolet (UV) rays from the sun or indoor tanning beds. Approximately 58 million Americans have one or more spots of actinic keratosis.

Non-cancerous actinic keratosis is not life-threatening. However, actinic keratosis is the most common type of skin precancer. Without treatment, actinic keratosis can turn into squamous cell carcinoma (a potentially invasive form of the disease).

The vast majority of squamous cell carcinomas start as actinic keratosis spots, so it’s important to visit a dermatologist as soon as possible.

What Are the Risk Factors for Actinic Keratosis?

Some people are at greater risk of actinic keratosis than others, including ones with:

Fair or light complexion
Blonde or red hair
Blue, green, or gray eyes

People with darker skin, hair, and eyes who’ve been exposed to UV rays without protection are still at risk, as well as older adults. Certain health issues also make us more vulnerable to actinic keratosis, including:

Weakened immune systems due to chemotherapy, HIV/AIDS, organ transplant, or other causes
Rare conditions that make the skin very sensitive to UV rays, such as albinism

What Are the Symptoms of Actinic Keratosis?

The rough, scaly patches of skin associated with actinic keratosis can be flat or slightly raised. Dimensions range from a tiny spot to as large as an inch in diameter. Color-wise, they may be red, tan, pink, flesh-colored, brown, or silver.

With so much variation, actinic keratosis symptoms are often felt more easily than seen. Your skin may feel sensitive, painful, or raw to the touch. Some patients feel an itchy, burning sensation. Actinic keratosis spots can even bleed or develop persistent sores in rare cases.

Actinic keratosis spots typically appear on sun-exposed areas of the face, lips, scalp, ears, shoulders, neck, hands, and arms. Another form of actinic keratosis (known as actinic cheilitis) affects the lower lip.

What’s the Most Effective Treatment for Actinic Keratosis?

The right actinic keratosis treatment for you will depend on several factors:

How many spots you have
Where they appear on your body
What they look like
If you’ve had skin cancer before
Other existing health conditions

Your dermatologist may recommend removing the spots during an office visit. Treatment options include:

Chemical peel – The chemicals safely destroy unwanted patches in your top layer of skin. The treated area will be sore and red for the first few days. But as the skin heals, a new, healthy layer of skin grows in its place.
Cryotherapy – Liquid nitrogen is used to freeze the spots, which should blister and peel off in a few days.
Photodynamic therapy – This treatment uses creams and special light therapy to destroy precancerous skin cells. You will need to stay out of the sun while your skin heals.
Excision – Your dermatologist scrapes away or cuts out the actinic keratosis spots and stitches the area back together. The wound should heal in 2-3 weeks.

For any of these treatments to be effective, they must destroy the actinic keratosis spots completely.

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