Actinic Keratosis

by Eileen Bailey Health Writer

Actinic Keratosis (AK), also called Solar Keratosis, is a pre-cancerous, pre-malignant rough spot on the skin. It is usually between 2 and 6 millimeters (somewhere between a pencil point and a pencil eraser) and is generally red, with a rough texture and a white or yellow scale on top. They may be painful when touched or when clothing rubs against them. They normally occur because of chronic over-exposure to the sun.

Actinic Keratosis is not cancer but can develop into squamous cell carcinoma if left untreated, although most do not become cancerous. However, it can take years before they turn into cancer. Treating these lesions early can help prevent them from turning into cancer later.

Who Is At Risk?

The Skin Cancer Foundation indicates that approximately 58 million Americans have actinic keratosis. Those who are most at risk have:

  • Fair complexions

  • Blond or red hair

  • Blue, green or grey eyes

  • Had a kidney or other transplant

  • Have a comprised immune system

  • Had severe sunburns as children

Even those at high risk must spend a lot of time in the sun in order to develop AK. Men tend to develop AK more often than women because they may spend more time outdoors in the sun and may not use sun screen as often as women do. Those who live closer to the equator are more at risk for developing AK than those who live further away from the equator.

Diagnosis of Acitinic Keratoses

Often, your medical provider can diagnosis AK by looking at your skin, however, your doctor may request a biopsy to see if it is cancerous.


There are a number of topical creams and lotions that have been found to be effective in treating AK. For those with many AKs, topical creams may be used in conjunction with other treatments. The most commonly used topical cream is 5-fluorouracil, which comes in both ointment and liquid and has been approved by the FDA for treatment of AK. Other topical agents include imiquimod 5% cream and diclofenac.

Other types of treatments that may be used for AK which have not improved with topical agents or if you have many lesions include:

  • Burning

  • Scraping the lesion away

  • Excision (cutting lesion out)

  • Cryosurgery

  • Chemical Peeling

  • Laser Surgery

  • Photodynamic Therapy

When treated early, treatment has been shown to be highly effective.


As with all risks of skin cancer, the most effective way to prevent AK is to avoid over-exposure to the sun's UV rays by:

  • Wearing protective clothing when out in the sun

  • Using sunscreens with a SPF rating of 15 or higher every day and reapplying when out in the sun for extended periods of time

  • Avoiding sun lamps and tanning beds

  • Avoiding being out in the sun midday when UV rays are the strongest

Because AK can take years to develop, it is important to continue to stay protected when in the sun, to be vigilant about skin self-exam and to see your doctor if you notice any new skin lesions or discolorations.


"Actinic Keratosis," Copyright 2012, Staff Writer, American Osteopathic College of Dermatology

"Actinic Keratosis," Reviewed 2011, Nov 22, Staff Writer, PubMed Health, U.S. National Library of Medicine

"Actinic Keratosis Treatment Options," Date Unknown, Staff Writer, The Skin Cancer Foundation

Eileen Bailey
Meet Our Writer
Eileen Bailey

Eileen Bailey is an award-winning author of six books on health and parenting topics and freelance writer specializing in health topics including ADHD, Anxiety, Sexual Health, Skin Care, Psoriasis and Skin Cancer. Her wish is to provide readers with relevant and practical information on health conditions to help them make informed decisions regarding their health care.