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Actinic Keratosis

Medical Author: Alan Rockoff, M.D.
Medical Editor: William C. Shiel, MD, FACP, FACR
Understanding Actinic Keratosis

Medical Author: Nili N. Alai, MD, FAAD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Learn about actinic keratosis (AK) diagnosis, treatment, and prevention.What are actinic keratoses?

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.

At what age do AKs develop?

Experts agree that AKs are most common in older adults and seniors. AKs are extremely rare in children or adolescents.

What are my chances of my precancers becoming skin cancers?

Anywhere from 5%-10% of AKs can potentially go on to become skin cancers. It is not possible to tell which ones will do this. Some AKs will never develop into anything else. Some AKs go away without treatment.

Do actinic keratoses ever turn into melanoma (a deadly form of skin cancer)?

No. While AKs may give rise to skin cancers like squamous cell carcinomas, they do not turn into melanomas. Nevertheless, it is important to keep in mind that people with AKs may be more prone to melanomas simply by having more sun damage.

Read on for AK treatment and prevention information »

What is an actinic keratosis?

An actinic keratosis (AK), also known as a solar keratosis, is a small, rough spot occurring on skin that has been chronically exposed to the sun. Actinic keratoses generally measure in size between 2 to 6 millimeters in diameter (between the size of a pencil point to that of an eraser). They are usually reddish in color and often have a white scale on top.

In addition to feeling rough, actinic keratoses may feel sore or painful when fingers or clothing rub against them.

Who is at risk for an actinic keratosis?

Those who develop actinic keratoses tend to be fair-skinned people who have spent a lot of time outdoors at work or at play over the course of many years. Their skin often becomes wrinkled, mottled, and discolored from sun exposure.

Where on the body do actinic keratoses typically occur?

Common locations for actinic keratoses are the face, scalp, back of the neck, upper chest, as well as the tops of the hands and forearms. Men are more likely to develop AKs on top of the ears, whereas women's hairstyles often protect this area.

What is the significance of an actinic keratosis?

Actinic keratoses are precancerous (premalignant), which means they can develop into skin cancer. However, relatively few of them actually become cancers, a process that typically takes years. When a malignant change does occur, the cancer is called a squamous cell carcinoma.

When patients are diagnosed with this condition, they often say: " But I never go out in the sun!" The explanation is that it takes many years or even decades for these keratoses to develop. Typically, the predisposing sun exposure may have occurred many years ago. Short periods of sun exposure do not generally either produce AKs or transform them into skin cancers.




Next: How is an actinic keratosis diagnosed? »

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