Actinic Keratosis (Solar Keratosis)

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

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 2-6 millimeters 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. Actinic keratosis often occurs against a background of sun damage, including sallowness, wrinkles, and superficial blood vessels.

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

Specialized forms of actinic keratoses include cutaneous horns, in which the skin protrudes in a thick, hornlike manner, and actinic cheilitis, which refers to scaling and roughness of the lower lip and blurring of the border of the lip and adjacent skin.

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 or who have exposed their skin to indoor tanning. Their skin often becomes wrinkled, mottled, and discolored from sun exposure. Others at risk for developing actinic keratoses include those who have their immune systems suppressed, such as organ transplant patients, as well as patients with psoriasis treated with PUVA therapy (topical long-wave ultraviolet light plus oral chemicals called psoralens.)



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

Understanding Actinic Keratosis

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

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.

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