Actinic keratoses are scaly, roughened spots most often found on the face, scalp, hands, arms or other areas with chronic sun exposure.
Actinic keratoses have also been called solar keratoses because they do result from sun (solar) and ultraviolet light exposure.
Some people describe them as a “gritty” feeling and may have tenderness when the lesion touched. Others have described it as a “cut” feeling. Occasionally patients will note that they appear when they go in the sun or that the scale disappears when they cleanse the area only to return.
Actinic keratoses most often occur in fair-skinned people but can happen to any skin type with chronic (long-term) sun exposure so skin type alone cannot be used to rule in or out this diagnosis. They may be dark, light, skin colored, pink, thickened and usually range from 2-6mm but can get much larger with a greater scale (hyperkeratotic actinic keratosis). Usually they can be felt first.
They usually appear in persons over the age of 30, but occasionally can occur in younger individuals who have had a lot of sun exposure.
There are many ways to treat actinic keratoses to include cryotherapy (liquid nitrogen), topical medications like 5-fluouracil and imiquimod, blue light therapy without or without aminolevulonic acid and chemical peels. Trichloracetic acid is most commonly used but glycolic acid and CO2 peels can be used as well as laser therapy.
If left untreated, they can progress to a type of skin cancer called squamous cell carcinoma.
If you are concerned that you have a precancerous lesion, please reach out to your board certified dermatologist for treatment.