Patient education: Actinic keratosis (The Basics)

What is actinic keratosis? — Actinic keratosis (AK) is a skin condition caused by sun damage. It causes scaly, rough, or bumpy spots on the skin (picture 1 and picture 2).

AK is most common in people who:

●Spend a lot of time outside, or did when they were young – People who work outside, such as farmers and lifeguards, have a higher risk of AK.

●Have fair (light) skin and hair

●Have freckles

●Sunburn easily

●Have skin that does not tan easily

AK is more common in older people. This is because sun damage builds up over time. Anyone can get AK, but it is more common in males than in females.

Having 1 or more painful sunburns in your life raises your risk of getting AK.

Common places for AK include the:

●Scalp, in people who are bald or have thinning hair

●Face

●Side of the neck

●Backs of the hands and forearms

●Legs or feet, especially in females

What are the symptoms of actinic keratosis? — AK looks like an abnormal area of skin. The area of skin can be:

●Red and scaly

●Red, thick or crusty

●Smooth and red

●Sticking up, pointed, and hard like a fingernail

One kind of AK can happen on the lip. It can cause a rough, dry, or scaly spot. The lip might also crack or get a sore on it.

Should I see a doctor or nurse? — Yes. Show your doctor or nurse any changes in your skin. AK can turn into a form of skin cancer called "squamous cell carcinoma."

Is there a test for actinic keratosis? — No, there is no 1 test. The doctor or nurse will do an exam and check your skin. They can usually tell if you have AK by looking at any skin changes and touching them.

If the doctor is not sure whether AK is causing the skin changes, you will have a test called a biopsy. You might also have a biopsy if a spot is hard, bleeding, growing quickly, or larger than a certain size.

During a biopsy, a doctor takes a small sample from the spot on your skin. Then another doctor looks at the skin under a microscope to check for skin cancer.

Doctors can also do a different test. In this test, they look at the skin with a small microscope that has a light on it. The doctor holds this over the area with skin changes. The microscope and light help them see under the skin. It can help show if a spot is AK or something else.

How is actinic keratosis treated? — A few people have AK that goes away on its own. This usually only happens in younger people. Most AK needs treatment. Without treatment, the spots can grow, spread, and turn into skin cancer.

The right treatment depends on the size of the AK, where it is on the body, and whether there are 1 or more spots.

Doctors can:

●Freeze the AK off with a special cold liquid (called liquid nitrogen)

●Do a procedure to remove the AK – This involves using special tools to scrape and burn or "cauterize" it off.

●Give you a strong cream or gel to put on the AK – The medicine in the cream or gel can get rid of the AK. If you have an area of skin with several spots, the doctor might tell you to put cream or gel on that whole area.

●Remove the AK with a strong chemical

●Do therapy with lights – In this treatment, a doctor puts cream on the skin. This makes it sensitive to a special kind of light. Then, they shine the special light on the skin.

What happens after treatment? — After treatment, you will need to be checked to see if your AK comes back or you get new spots. The doctor will do an exam and check your skin for changes. You should also keep checking your skin for any new changes. Show any changes you find to your doctor or nurse.

Can actinic keratosis be prevented? — Yes. You can help prevent AK by protecting your skin from the sun. To lower the chance of getting AK, you can:

●Stay out of the sun in the middle of the day (from 10 a.m. to 4 p.m.)

●Wear sunscreen – An SPF of at least 30 is best.

●Wear a wide-brimmed hat, long-sleeved shirt, long pants, or long skirt outside

●Not use tanning beds

Even if you already had treatment for AK, protecting your skin can help keep you from getting more.

More on this topic

Patient education: Skin cancer (non-melanoma) (The Basics)
Patient education: Sunburn (The Basics)

Patient education: Sunburn prevention (Beyond the Basics)
Patient education: Sunburn (Beyond the Basics)