Definition

Actinic keratosis (AK) is a rough, scaly, or crusted patch of skin. It often happens from being in the sun. It is not cancer, but it can change to squamous cell skin cancer.

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Causes

AK is caused by damage from the sun or indoor tanning machines.

Risk Factors

AK is more common in older adults. It is also more common men. Other things that may raise the risk are:

  • Fair skin color
  • Living in sunny places
  • Having a weak immune system, such as from an organ transplant
  • Having xeroderma pigmentosum—a rare genetic disorder that causes increased sensitivity to the sun's rays
  • Having chronic lymphocytic leukemia—a cancer of the blood and bone marrow

Symptoms

A person may have a rough, scaly, or crusted patch of skin.

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

A biopsy may be done. The skin will be checked for cancer in a lab.

Treatment

Treatment depends on whether the AK is mild or severe. A mild AK may be watched to check for changes over time. A severe AK may be treated to lower the risk of skin cancer. This may be done with:

  • Cryosurgery
  • Surgery
  • Medicine put on the skin over time to remove the AK
  • Photodynamic therapy (may be combined with laser treatment)

Prevention

To lower the chance of getting AK:

  • Limit time in the sun.
  • Wear clothing that covers skin that is exposed to the sun.
  • Do not use indoor tanning machines.
  • Use sunscreen with an SPF of at least 30.
RESOURCES:

American Academy of Dermatology
http://www.aad.org

American Osteopathic College of Dermatology
http://www.aocd.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Canadian Dermatology Association
http://www.dermatology.ca

REFERENCES:

Actinic keratosis. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/actinic-keratosis. Updated August 13, 2019. Accessed November 19, 2019.

Actinic keratosis. The Skin Cancer Foundation website. Available at: http://www.skincancer.org/skin-cancer-information/actinic-keratosis. Updated May 2019. Accessed November 19, 2019.

de Berker D, McGregor JM, et al. British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol. 2017 Jan;176(1):20-43.

Sunscreen FAQs. American Academy of Dermatology website. Available at: https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreen-faqs. Accessed November 19, 2019.

Last reviewed September 2019 by EBSCO Medical Review Board James P. Cornell, MD