Find out more about this skin condition that causes a rough, scaly patch after years of ultraviolet exposure from the sun or indoor tanning.
An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of sun exposure. It's often found on the face, lips, ears, forearms, scalp, neck or back of the hands.
Also known as a solar keratosis, an actinic keratosis grows slowly and usually first appears in people over 40. You can reduce your risk of this skin condition by minimizing your sun exposure and protecting your skin from ultraviolet (UV) rays.
Left untreated, the risk of actinic keratoses turning into a type of skin cancer called squamous cell carcinoma is about 5% to 10%.
Actinic keratoses are scaly spots or patches on the top layer of skin. With time they may become hard with a wartlike surface.
Actinic keratoses vary in appearance. Symptoms include:
It can be difficult to distinguish between noncancerous spots and cancerous ones. So it's best to have new skin changes evaluated by a health care provider — especially if a scaly spot or patch persists, grows or bleeds.
An actinic keratosis is caused by frequent or intense exposure to UV rays from the sun or tanning beds.
Anyone can develop actinic keratoses. But you're at increased risk if you:
If treated early, actinic keratosis can be cleared up or removed. If left untreated, some of these spots might progress to squamous cell carcinoma. This is a type of cancer that usually isn't life-threatening if detected and treated early.
Sun safety helps prevent actinic keratoses. Take these steps to protect your skin from the sun:
Use sunscreen. Before spending time outdoors, apply a broad-spectrum water-resistant sunscreen with a sun protection factor (SPF) of at least 30, as the American Academy of Dermatology recommends. Do this even on cloudy days.
Use sunscreen on all exposed skin. And use lip balm with sunscreen on your lips. Apply sunscreen at least 15 minutes before going outside and reapply it every two hours — or more often if you're swimming or sweating.
Sunscreen is not recommended for babies under 6 months. Rather, keep them out of the sun if possible. Or protect them with shade, hats, and clothing that covers the arms and legs.
Your health care provider will likely be able to determine whether you have an actinic keratosis simply by looking at your skin. If there's any doubt, your health care provider may do other tests, such as a skin biopsy. During a skin biopsy, a small sample of skin is taken for analysis in a lab. A biopsy can usually be done in a clinic after a numbing injection.
Even after treatment for actinic keratosis, your health care provider might suggest that you have your skin checked at least once a year for signs of skin cancer.
An actinic keratosis sometimes disappears on its own but might return after more sun exposure. It's hard to tell which actinic keratoses will develop into skin cancer, so they're usually removed as a precaution.
If you have several actinic keratoses, your health care provider might prescribe a medicated cream or gel to remove them, such as fluorouracil (Carac, Efudex others), imiquimod (Aldara, Zyclara) or diclofenac. These products might cause inflamed skin, scaling or a burning sensation for a few weeks.
Many methods are used to remove actinic keratosis, including:
You're likely to start by seeing your primary care provider. In some cases when you call to set up an appointment, you may be referred directly to a specialist in skin diseases (dermatologist).
Your time with your health care provider is limited, so preparing a list of questions will help you make the most of your appointment. For actinic keratoses, some basic questions to ask include:
Questions your health care provider may ask you include: