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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What is the significance of an actinic keratosis?

Actinic keratoses are precancerous (premalignant), which means they may develop into invasive skin cancer. Although the chance of an individual actinic keratosis progressing into an invasive squamous cell carcinoma is less than 1%, patients with many of these lesions (very common) who continue to expose their skin to carcinogenic ultraviolet sunlight are likely to develop invasive skin cancers. Squamous cell skin cancers are locally destructive and have a small but real potential for metastasis (spreading to other areas). Treating actinic keratoses at an early stage will help prevent invasive skin cancer. When patients are diagnosed with this condition, they often say, "But I never go out in the sun!" The explanation for this is that there can be a long delay, even decades, for these keratoses to develop. Short periods of sun exposure do not generally either produce actinic keratoses or transform them into skin cancers.

What specialists diagnose actinic keratoses?

Generally, primary-care physicians or dermatologists can diagnose and care for actinic keratosis. If the lesion is especially large or thick, a biopsy may be advisable to make sure that the spot in question has not become a skin cancer.

There are other spots, called seborrheic keratoses, which are not caused by sun exposure and have no relationship to skin cancers. These are raised brown lesions that may appear on any area of the skin. They also often run in families.

Medically Reviewed by a Doctor on 9/2/2016

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