Actinic Keratosis (AK) Treatment
Treat precancerous sun damage early and reduce your risk of skin cancer.
Actinic Keratosis Is More Than Sun Damage—It’s a Warning Sign
Actinic Keratosis (AK) is one of the most common precancerous skin conditions, affecting over 40 million Americans each year. Also known as solar keratosis, these rough, scaly patches typically develop on areas of the skin frequently exposed to ultraviolet (UV) rays from the sun, sunlamps, or tanning beds.
If left untreated, some AKs may progress into Squamous Cell Carcinoma (SCC), a more serious form of skin cancer. Early identification and management of AK are crucial for preventing this progression and maintaining healthy skin.
At Phoenix Surgical Dermatology Group, we offer expert diagnosis and personalized treatment plans for actinic keratosis to help patients protect their skin and reduce cancer risks.
What is Actinic Keratosis (AK)?
Actinic keratosis represents abnormal growths of the outermost skin cells, caused by cumulative UV damage over time. These lesions often form on sun-exposed areas, including:
- Face
- Scalp (especially in balding men)
- Ears
- Neck
- Forearms and hands
- Shoulders
- Lips (where it is known as actinic cheilitis)
While not all AKs will become cancerous, studies show that
about 10% may develop into squamous cell carcinoma if left untreated.
Signs and Symptoms of Actinic Keratosis
AK lesions can vary in appearance but are often easier to feel than to see. Common characteristics include:
- Rough, sandpaper-like texture
- Scaly, crusty patches or bumps
- Colors ranging from red, pink, or skin-toned to gray or white
- Lesions that never fully heal, or heal and then return
- White patches on the lips (actinic cheilitis)
- In some cases, horn-like growths (cutaneous horns), which signal higher risk of cancerous transformation
- Itching, burning, stinging, tenderness, or bleeding at the site
AK lesions often appear in
clusters and may fluctuate in visibility, becoming more noticeable after sun exposure.
Who Is at Risk for Developing Actinic Keratosis?
Anyone with significant sun exposure can develop AK, but certain groups are at higher risk:
- Individuals with
fair skin, especially those who burn easily and rarely tan
- People with
naturally red or blond hair and
light-colored eyes
- Age over 50, though younger people who use tanning beds are also at risk
- History of
chronic sun exposure or outdoor work/lifestyle
- Weakened immune systems, such as organ transplant recipients or those on immunosuppressive therapy
- Use of
photosensitizing medications
- Genetic conditions that increase sensitivity to sunlight (e.g., xeroderma pigmentosum)
How is Actinic Keratosis Diagnosed?
Diagnosis typically begins with a visual and physical examination by a board-certified dermatologist, who may:
- Review your medical history and sun exposure habits
- Carefully inspect and feel the skin, especially sun-exposed areas
- In some cases, perform a skin biopsy to rule out squamous cell carcinoma if the lesion appears suspicious or unusual
Most AKs can be diagnosed based on appearance and texture alone, making early intervention easier and more effective.
Treatment Options for Actinic Keratosis
Treatment for AK depends on factors such as the
number of lesions, their
location,
appearance, and your
overall health history. Most treatments are performed
in-office and may be combined with
at-home topical therapies for optimal results.
In-Office Treatments
- Cryotherapy: Freezing the lesion with liquid nitrogen; ideal for visible, individual AKs.
- Chemical Peels: Medical-grade chemical solutions remove the top skin layers, effective for multiple lesions.
- Curettage and Electrodessication: Scraping away thick lesions, followed by electric current to destroy remaining abnormal cells.
- Photodynamic Therapy (PDT): A two-part process involving a light-sensitizing agent applied to the skin, followed by activation with blue or red light to destroy AK cells. Typically requires two treatments spaced three weeks apart.
- Laser Resurfacing: Removal of the skin’s outer layer with a specialized laser, promoting new healthy skin growth.
At-Home Prescription Treatments (Topical Medications):
- 5-Fluorouracil (5-FU) Cream:
Applied once or twice daily for 2 to 4 weeks; induces intense skin reaction and peeling.
- Diclofenac Sodium Gel: Applied twice daily for 2 to 3 months; generally causes less irritation than 5-FU.
- Imiquimod Cream:
Boosts the immune response; often used on the face, applied once or twice weekly for 12 to 16 weeks.
- Ingenol Mebutate Gel:
Shortest treatment duration—3 days for face/scalp, 2 days for other body areas.
- Calcipotriene Cream: Often combined with 5-FU to enhance effectiveness and shorten treatment time.
- Combination therapy—pairing in-office procedures with prescription creams—may be recommended for the most effective results.
Why Early Detection and Treatment of Actinic Keratosis Matters
Treating AK early prevents the progression to squamous cell carcinoma and minimizes cosmetic damage to the skin. Because AK often recurs or new lesions may develop over time,
ongoing monitoring and annual skin exams are important for continued skin health.
Frequently Asked Questions About Actinic Keratosis
Is actinic keratosis considered skin cancer?
No, actinic keratosis is classified as a precancerous lesion. However, if left untreated, some AKs can progress into squamous cell carcinoma, a form of skin cancer.
Can actinic keratosis go away on its own?
In rare cases, AK may disappear temporarily but often returns. Because of the risk of progression to cancer, treatment is recommended even if the lesion seems to resolve.
How do I know if I have actinic keratosis or something else?
AKs typically feel rough, like sandpaper, and may appear scaly or crusty. If you notice any persistent or unusual skin changes, schedule a skin exam with a dermatologist for an accurate diagnosis.
What is the best treatment for actinic keratosis?
The best treatment depends on the number, size, and location of the lesions. Cryotherapy, photodynamic therapy, and topical creams are commonly used, often in combination for effective management.
How can I prevent actinic keratosis?
Reduce your risk by:
- Wearing broad-spectrum sunscreen with SPF 30 or higher daily
- Avoiding tanning beds
- Wearing protective clothing, wide-brimmed hats, and sunglasses
- Seeking shade during peak sun hours (10 AM–4 PM)
- Scheduling annual skin cancer screenings
Schedule Your Schedule Your Actinic Keratosis Evaluation Today
If you’re concerned about rough, scaly patches on your skin, don’t wait. Contact Phoenix Surgical Dermatology Group to schedule a professional skin evaluation. Our board-certified dermatologists offer advanced treatments to help you protect your skin and reduce your risk of skin cancer.
Early detection and treatment make all the difference.
