Actinic Keratosis: What You Need to Know

Notice a rough, scaly patch on sun‑exposed skin? That could be actinic keratosis (AK). It’s a common precancerous spot caused by years of UV damage. Most AKs are harmless at first, but some turn into a type of skin cancer called squamous cell carcinoma if left alone. The good news: when caught early, AKs are easy to treat and often preventable.

What it looks like and who gets it

AKs are usually small (less than 1 inch), rough, and sandpapery. They often sit on the face, ears, scalp, lips, forearms or hands. Color varies—pink, red, brown, or skin‑colored. They might itch, sting, or flake, but sometimes they don’t cause any symptoms at all.

You're more likely to get AKs if you have fair skin, light hair or eyes, a history of sunburns, or frequent sun exposure (outdoor jobs, tanning beds). People over 40 see them more often, but younger folks with heavy sun exposure can get them too.

Treatments and simple prevention steps

Treatment choice depends on how many lesions you have and where they are. Common options your doctor may suggest:

- Cryotherapy: Freezing the spot with liquid nitrogen. Quick, often done in a clinic, may leave a blister or light scarring.

- Topical medicines: 5‑fluorouracil (5‑FU), imiquimod, or diclofenac creams treat areas with several AKs. They cause redness and peeling while clearing abnormal cells over weeks.

- Photodynamic therapy (PDT): A light‑activated treatment that targets abnormal cells across a treated area. Good when you have many AKs in one place.

- Curettage and excision: Physically scraping or cutting out thicker or suspicious lesions. Used when a biopsy is needed.

After treatment, follow your doctor’s advice on wound care and sun protection. You’ll often need repeat checks—AKs can come back, especially in people with past heavy sun exposure.

Prevention is straightforward and effective:

- Use broad‑spectrum SPF 30+ every day and reapply every two hours when outdoors.

- Wear sun‑protective clothing, a wide‑brim hat, and sunglasses.

- Avoid tanning beds and midday sun (10am–4pm).

- Check your skin monthly and get a professional skin exam at least once a year if you’ve had AKs or lots of sun exposure.

When to see a doctor? Make an appointment if a spot grows, changes color, bleeds, becomes painful, or won’t heal. Also see a dermatologist if you have multiple rough patches—treating a whole area early reduces cancer risk.

If you want help deciding treatment or finding a trustworthy clinic, a dermatologist can explain options, likely side effects, and recovery time. Small steps now—sun protection and regular checks—go a long way toward keeping your skin healthy.