Actinic Keratosis (Solar Keratosis)

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Learn about actinic keratosis (AK) diagnosis, treatment, and prevention.

Understanding Actinic Keratosis

Actinic keratoses (AKs) are small, red, rough, scaly, flat spots that feel like dry skin patches. They often occur on sun-exposed areas, such as the nose, ears, face, chest, forearms, and back of the hands. Other common names include AK, AKs, solar keratosis, precancers, and pre-skin cancers.

Picture of actinic keratosis

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Sun-Damaged Skin Pictures Slideshow

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 physical examination.
  • The best treatment for an actinic keratoses is prevention by minimizing sun exposure.
  • Treatments for actinic keratoses include cryosurgery, scraping or burning, 5-fluorouracil cream, imiquimod (Aldara), diclofenac (Voltaren, Cataflam, Voltaren-XR, Cambia), ingenol mebutate (Picato), TCA skin peels, and photodynamic therapy.

What is an actinic keratosis, and what does it look like?

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 excess superficial blood vessels. Actinic keratosis is also referred to as a solar keratosis.

Specialized forms of actinic keratoses include cutaneous horns, in which the skin protrudes in a thick, hornlike manner, and actinic cheilitis, a scaling and roughness of the lower lip and blurring of the border of the lip and adjacent skin. There are other causes of cutaneous horns, including warts and age spots (seborrheic keratoses).

Medically Reviewed by a Doctor on 2/23/2015
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