Actinic keratoses (AKs) are rough, scaly skin patches caused by long-term sun exposure. They are considered precancerous because some can develop squamous cell carcinoma, a form of skin cancer.
AKs are very common. An estimated 40 million Americans develop them each year. While not all AKs become cancer, doctors treat them early to reduce risk and prevent skin damage from worsening.
Many people do not notice actinic keratoses right away. The spots are often easier to feel than see and may slowly change over time.
At Goodskin Dermatology in Portland, OR, our board-certified dermatologists diagnose and treat actinic keratoses with personalized care based on your skin health and risk factors.
Keep reading to learn how to recognize actinic keratoses symptoms, understand your risk factors and explore treatment options.
What Are Actinic Keratoses?
Actinic keratoses are precancerous skin growths caused by long-term UV exposure from the sun or tanning beds. UV damage changes skin cells over time and leads to rough, scaly patches on the skin.
Actinic keratoses may remain stable, grow slowly or in some cases progress into squamous cell carcinoma.
They are most common in adults over 40 and in people with a history of frequent sun exposure.
Why They’re Called ‘Actinic’
The word ‘actinic’ refers to damage caused by sunlight or UV radiation. ‘Keratosis’ refers to thickened or rough skin.
Together, the term describes rough skin changes caused by long-term sun damage.
How Common Are They?
Actinic keratoses are very common. According to the American Academy of Dermatology Association, about 40 million Americans develop AKs each year.
They are more common in people with fair skin, light eyes and a history of outdoor sun exposure.
What Do Actinic Keratoses Look, Feel And Act Like?
Actinic keratoses symptoms can vary, but they often start as small patches of rough or dry skin.
Common signs include:
- Rough or sandpaper-like texture
- Dry, scaly or crusted patches
- Pink, red, brown or skin-colored spots
- Mild itching, tenderness or burning
- Spots that do not fully heal
Many people first notice AKs by touch before they see them.
Common Locations On The Body
Actinic keratoses usually appear on areas that receive the most sun exposure, including:
- Face
- Scalp
- Ears
- Neck
- Chest
- Forearms
- Back of the hands
- Lower legs
When To Take Notice
It is important to have any persistent rough or scaly spot evaluated by a board-certified dermatologist, especially if it:
- Grows quickly
- Becomes painful
- Bleeds easily
- Changes color
- Develops a thick or raised surface
These changes may indicate a higher risk of skin cancer and should be evaluated promptly.
Risk Factors: Who Develops Actinic Keratoses?
Several factors can increase the risk of actinic keratoses. The main cause is long-term sun exposure that builds up over time.
People at higher risk include:
- Adults over age 40
- People with fair skin, light eyes or light hair
- Those with frequent sunburns in the past
- People who use tanning beds
- Outdoor workers or those with high sun exposure
- People with weakened immune systems
- Patient with a history of skin cancer
Even people who use sunscreen can develop actinic keratoses due to many years of cumulative UV exposure.
Can Actinic Keratoses Become Cancer?
Yes. Actinic keratoses are considered precancerous because some can turn into squamous cell carcinoma (SCC), a common and potentially invasive form of skin cancer.
While only about five to ten percent of AKs become cancerous, it is impossible to predict which ones will progress. Because of this uncertainty, dermatologists often recommend treatment instead of monitoring alone.
Early treatment helps lower the risk of skin cancer and can prevent lesions from becoming thicker or more difficult to treat.
Understanding skin cancer, its risk factors and warning signs, can help you understand what to look for and when you need to seek help.
How Actinic Keratoses Are Diagnosed At Goodskin Dermatology
Actinic keratoses are diagnosed by a board-certified dermatologist through a careful skin exam.
During a full-body skin evaluation, your provider will examine the skin for rough or unusual lesions and check for signs of sun damage.
Most actinic keratoses can be diagnosed with a visual exam and dermoscopy. Dermoscopy is a handheld tool that allows the dermatologist to see skin structures more clearly.
If a spot looks unusual or concerning, a skin biopsy may be recommended. A biopsy removes a small sample of skin so it can be checked under a microscope.
At Goodskin Dermatology, our board-certified dermatologists explain every step clearly, so you understand your diagnosis and next steps.
Treatment Options For Actinic Keratoses At Goodskin Dermatology
Actinic keratosis treatment depends on how many lesions you have, where they’re located and your overall skin health.
At Goodskin Dermatology, our board-certified dermatologists create personalized treatment plans to remove existing lesions and help reduce future sun damage.
Cryotherapy (Liquid Nitrogen)
Cryotherapy for actinic keratosis is one of the most a common treatments for individual lesions.
During treatment, liquid nitrogen is applied to freeze the damaged skin cells. The treated spot may become red or crusted and then slowly heal as new skin forms.
Cryotherapy is:
- Fast and done in-office
- Effective for single lesions
- Low downtime for most patients
Topical Medications
Prescription creams or gels may be used when actinic keratoses cover larger areas of skin.
These medications treat visible lesions and also target sun-damaged skin that may not yet be visible.
Topical medications can:
- Treat multiple lesions at the same time
- Improve rough or scaly skin
- Treat broader areas of sun damage
Your dermatologist will explain how to use the medication and what to expect during treatment.
Photodynamic Therapy (PDT)
Photodynamic therapy for AKs uses a light-sensitive medication and a special light source to destroy damaged skin cells.
PDT is often used doe areas with multiple AKs, especially on the face or scalp.
PDT can:
- Treat several lesions in one visit
- Target damaged cells with more precisely
- Improve skin texture over time
Other Approaches
Some patients benefit from chemical peels or other field therapies that treat larger areas of sun-damaged skin.
Regular Medical Dermatology visits and skin checks can help detect new lesions early and support long-term skin health.
Frequently Asked Questions
Are actinic keratoses the same as age spots?
No. Age spots are flat areas of darker pigment. Actinic keratoses are rough, scaly precancerous growths caused by sun damage.
Can actinic keratoses go away on their own?
Some actinic keratoses may improve for a short time, but many return. Because they can become skin cancer, evaluation and treatment are recommended.
How do I know if an actinic keratosis is turning into skin cancer?
Warning signs include rapid growth, bleeding, pain, thickening or color changes. Any changing lesion should be checked by a dermatologist.
Is one treatment enough, or will I need follow-up?
This depends on how many actinic keratoses you have, how large the affected area is and how your skin responds to treatment.
Some patients only need a single treatment. Others may need follow-up visits or repeat therapy.
Follow-up care helps your dermatologist monitor healing and detect new lesions early.
How can I prevent new actinic keratoses from forming?
To help reduce additional UV damage and lower your risk of new actinic keratoses lesions:
- Use broad-spectrum SPF 30+ sunscreen every day
- Wear hats, sunglasses and sun-protective clothing
- Avoid tanning beds
Regular skin exams with a board-certified dermatologist are also important, especially if you have a personal or family history of actinic keratoses or skin cancer.
Schedule An Appointment At Goodskin Dermatology
If you notice rough, scaly or persistent skin spots, the board-certified dermatologists at Goodskin Dermatology can evaluate your skin and recommend treatment.
We provide care for patients across the Portland area, including Clackamas, Hillsboro, Troutdale and Beaverton at Cedar Hills Crossing.
