Actinic Keratosis: The Most Common Precancerous Skin Lesion

by Anne Windermere Patient Advocate

There are some skin conditions that may be a precursor for developing skin cancer. One type of precancerous skin lesion is an atypical mole which may develop into melanoma. Another type of precancerous skin lesion is called actinic keratosis or as it is sometimes called, solar keratosis. This is the most common precancerous skin condition which in some instances can develop into squamous cell carcinoma especially if left untreated.

This is of special concern because squamous cell skin cancer can be invasive and in some instances life threatening. Actinic Keratoses are areas of skin which have been damaged by years of exposure to ultraviolet radiation from the sun. In addition the use of tanning beds can also greatly increase the cumulative effects of skin damage and can subsequently increase your risk for developing actinic keratoses or even skin cancer.

These rough and scaly growths can appear anywhere but normally develop on areas of the body most exposed to the sun such as the face, neck, ears, scalp, arms, and the backs of your hands.

What does actinic keratosis look like?

The image at the top of this article provides a close up of what this type of lesion can look like. Additional images may be viewed on Health Central's actinic keratosis page.

The appearance of these lesions can vary greatly so any new growth or unexplained lesion should be promptly investigated by your doctor.

Here are some things you should know about the appearance and symptoms of actinic keratosis:

  • In the early stages actinic keratoses may be so small that you are most able to detect them through touch instead of by sight. They are said to feel much like sandpaper.

  • When visible, these skin lesions are usually reddish brown patches with a rough texture. They occur in clusters and are generally 1-3 mm in size.

  • The color of the lesions may vary from pink, tan, or they can be the same color as your skin. Most will become reddish brown.

  • These lesions can sometimes itch and burn. They can become inflamed and cause redness to the surrounding skin. In rare instances they can even bleed.

  • Actinic keratoses generally grow slowly and early on they may disappear only to reappear later.

  • Some of these lesions may grow hard and wart-like or even develop into a horn like growth.

Who gets actinic keratoses?

As mentioned in the title of this post, actinic keratosis is the most common precancerous skin condition affecting more than ten million Americans according to The National Skin Cancer Foundation.

You may be more at risk for developing actinic keratosis if you:

  • Are above the age of fifty. The amount of sun damage is greater for those who are older as they have had more years of cumulative sun damage. There are some skin cancer experts who believe that most everyone who is above the age of 80 has actinic keratoses.

  • Have a fair complexion, blonde or red hair, or blue, green or grey eyes. These traits seem to put the individual at more risk for not only precancerous lesions but for most types of skin cancer.

  • Have spent a lot of time in the sun over the years without using much protection or you live close to the equator.

  • Are male. Some speculate that more men have actinic keratosis because they spend more time in the sun without proper protection than women do.

  • Have a weakened immune system. People who are undergoing chemotherapy for cancer, have AIDS, or have undergone an organ transplant are less able to use their body's natural defense system against the effects of ultraviolet radiation.

What is the treatment for actinic keratoses?

As mentioned previously you do want to get these sun damaged areas of skin looked at by a doctor and preferably a dermatologist. The reason is that left untreated some actinic keratoses may develop into squamous cell carcinoma.

According to The Skin Cancer Foundation between 40-60 percent of squamous cell carcinomas begin as untreated actinic keratoses. One preventive measure is to get an annual skin examination by a dermatologist every year to examine any new skin lesions for possible cancer.

There are many possible treatments to remove actinic keratoses which may include:

  • Burning the growth off with electrical cautery.

  • Surgical excision of the lesion.

  • Cryotherapy which destroys the cells through freezing them.

  • Laser therapy.

  • Curettage and electrodesiccation where they scrape the lesion and use electricity to destroy any remaining cells.

  • Topical medications may also be used. Our Dr. Kevin Berman goes into great detail about how medications such as Efudex, Carac, Aldara, and Solaraze can be used to treat actinic keratoses.

For more information about actinic keratosis please refer to the following resources:

Anne Windermere
Meet Our Writer
Anne Windermere

These articles were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Merely Me."