An actinic keratosis is a precancerous growth on the skin that forms due to long-term exposure to UV light. It is also known as solar keratosis.

Actinic keratosis growths often appear in groups. The condition surfaces most often on areas of the body that get regular sunlight exposure.

Precancerous means that the condition can progress to cancer without treatment. As a result, it is essential for doctors to monitor actinic keratosis and treat it where appropriate.

This article details the causes, symptoms, and treatment of actinic keratosis.

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An actinic keratosis is a rough and often bumpy patch or lesion that forms on the skin. These lesions most commonly appear on the:

  • scalp
  • backs of the hands
  • face
  • ears
  • back of the forearms
  • neck
  • shoulders

Actinic keratoses develop over several years. In most cases, they present in people aged 50 years or older. About 58 million people in the United States have at least one actinic keratosis.

The size of actinic keratoses varies from tiny to an inch or more in diameter. Similarly, color variations range from light to dark with variations throughout the patches. Although in most cases, there are no other signs or symptoms, some people can experience itching, tenderness, and stinging.

Developing an actinic keratosis increases a person’s risk of skin cancer. Without treatment, it may develop into squamous cell carcinoma, a type of skin cancer.

Appearance

Knowing what to look for can help a person spot an actinic keratosis early on so that they can bring it to a doctor’s attention.

No two cases of actinic keratosis will look the same, but they may share the following similar features:

  • raised areas of skin discoloration
  • rough, scaly bumps
  • multiple scaly spots that look similar to acne
  • crusty patches

Actinic keratoses occur when overexposure to UV light damages skin cells.

Unlike sunburn, which is an immediate reaction to prolonged exposure to UV light, it takes years of regular sun exposure for actinic keratosis lesions to develop.

Risk factors

Anyone can develop actinic keratoses over time. However, certain risk factors make people more likely to develop them.

These factors include:

  • being aged 50 years or older
  • a history of sunburn or extreme sun exposure
  • living in a sunny environment
  • using tanning beds
  • a history of actinic keratosis
  • having light colored hair or eyes
  • tending to burn in the sun

In many cases, a person will notice the small patch of skin that develops with this condition. As with all skin changes or newly discovered bumps, a person should see their doctor as soon as possible to help catch any problems early.

A doctor or dermatologist is likely to be able to diagnose an actinic keratosis with a simple visual examination. They may order a skin biopsy and send a sample for laboratory testing if necessary.

The main methods of prevention of actinic keratosis are through lifestyle changes. A person should take proper precautions when outside, such as:

  • wearing sunscreen daily
  • avoiding prolonged sun exposure
  • covering up their skin when in direct sunlight

It is also important to remember that this condition may occur from any UV light source, including indoor tanning beds.

A person can ensure the timely diagnosis and treatment of actinic keratosis by regularly checking their skin for symptoms and contacting a healthcare professional if they discover any changes.

Doctors may recommend several different treatment options for actinic keratosis. These can be critical in stopping the condition from progressing to cancer.

Treatment may involve a combination of:

  • medication
  • surgery
  • photodynamic therapy, which uses drugs and light to kill cancerous and precancerous cells

The composition of treatment plans will vary depending on the person’s preference and the severity of their symptoms. Close adherence to the chosen treatment plan is critical to ensure the best possible outcome.

Medication

Doctors may recommend topical creams and ointments for widespread cases of actinic keratosis. Some medicated creams include:

  • diclofenac sodium gel
  • imiquimod cream
  • 5-fluorouracil cream

Surgery

In cases where a person only has a few spots or patches, a doctor may recommend removing the affected area through minor surgery.

Surgical procedures for actinic keratosis include:

  • Cryotherapy: In cryotherapy, a doctor applies liquid nitrogen to the skin, which causes the affected area to blister and peel. As the skin heals, the lesions fall off, allowing new, undamaged skin to appear.
  • Curettage: This procedure is also known as scraping. A doctor will use a device called a curette to scrape off the damaged skin cells.
  • Electrosurgery: Doctors may perform this after curettage. Electrosurgery involves a doctor using a pen-shaped instrument to destroy any remaining abnormal tissue and provide hemostasis. Hemostasis is the body’s natural response to stop bleeding.
  • Chemical peels: In this procedure, a healthcare professional will apply a chemical to the affected area. This will destroy the top layer of skin and the actinic keratoses on it.
  • Photodynamic therapy: Photodynamic therapy involves the topical application of a solution that makes the skin sensitive to light. The doctor then shines an artificial light that activates the solution and kills the damaged cells.

People with an actinic keratosis are at risk of developing cancer if they do not receive appropriate treatment for the condition.

The earlier a doctor can diagnose and treat an actinic keratosis, the lower the risk of skin cancer.

Following treatment, people may require repeat visits to a dermatologist. These are often yearly but will be more frequent for people with compromised immune function.

An actinic keratosis is a precancerous growth on the skin. It is the result of skin damage from UV exposure. These growths may appear as bumps, scales, or patches of rough, crusty skin.

Millions of people in the U.S. have at least one actinic keratosis, and they are more common in older people. Early diagnosis and treatment of actinic keratoses can prevent them from developing into skin cancer.