Understanding Actinic Keratosis

Actinic keratosis is a skin growth caused by ultraviolet (UV) rays from sun exposure or tanning beds. These growths are usually not cancer, but they may develop into skin cancer (precancerous). Many people get these growths, especially as they age. This is because of the many years of sun exposure. Multiple growths are called actinic keratoses.

What causes actinic keratosis?

Sun damage causes actinic keratosis. These growths usually appear on skin that is most often exposed to the sun, such as the face, ears, or back of the hands. People who easily sunburn are more likely to develop actinic keratoses. Actinic keratoses often appear later in life from long-term sun exposure.

What are the symptoms of actinic keratosis?

Actinic keratosis growths may be described as:

• Rough, like sandpaper

• Wartlike

• Scaly or scabby

• More easily felt than seen

They may appear singly or in clusters. They may start out as red patches. The skin around them may be discolored.

Actinic keratoses usually are not painful. For some people they may make the skin feel tender.

How is actinic keratosis treated?

Because actinic keratoses may develop into skin cancer, a healthcare provider should look at them. Your healthcare provider may choose to remove one or more of these growths. It may be looked at under a microscope. This is called a biopsy. Your healthcare provider may remove or destroy actinic keratoses to prevent them from turning into skin cancer. You may also wish to have actinic keratoses removed if they bother you. They can be removed in several ways:

• By using a medicine on the skin such as diclofenac sodium gel, 5-fluorouracil, imiquimod, or tirbanibulin.

• By removing them with a scalpel. This makes it possible to have the tissue tested (biopsy).

• By freezing them off by applying liquid nitrogen to the growth.

• By treating the area with photodynamic therapy. In this procedure, a medication is applied to the skin to make it sensitive to light. The medicine is then activated with a special medical light, a laser, or carefully controlled sunlight.

How can I prevent actinic keratoses?

Preventing sun damage to your skin is the best way to prevent actinic keratoses. Here are some ways to protect your skin:

• Use sunscreen with an SPF of 30 or higher on exposed skin when you are outside.

• Wear a hat to protect your face and scalp. Consider wearing clothing that covers your arms and legs.

• Stay out of the sun in the middle of the day, when sunlight is most direct.

• Be aware of how long you have been out in the sun. Reapply sunscreen according to package directions.

• Don't use tanning beds.

Always use sunscreen when you are outside.

What are possible complications of actinic keratosis?

Actinic keratoses are a sign of skin damage. They may become cancerous. It’s a good idea to ask your healthcare provider to check new skin growths. Report any skin problem that concerns you.

When should I call my healthcare provider?

Call your healthcare provider right away if any of these occur:

• You have an actinic keratosis sore that does not respond to treatment

• You have an actinic keratosis sore that does not heal within a few weeks or heals and then comes back

• You have a skin growth that is changing in size, shape, or color

• You have a skin growth that looks different on one side from the other

• You have a skin growth that is not the same color throughout