Actinic Keratosis: Spot the Sun-Damaged Patches Early

Actinic keratosis (AK) shows up as rough, scaly spots on skin exposed to the sun. They’re common on the face, ears, scalp, hands, and forearms. Most AKs are harmless at first, but some can turn into squamous cell carcinoma, a type of skin cancer. Knowing how to spot, treat, and prevent them helps you avoid bigger problems later.

What it looks like and why it matters

AKs feel like a small, gritty patch or a raised bump. Colors vary: pink, red, brown, or the same as your skin. They can itch, sting, or crust over. If a patch keeps growing, bleeds easily, or becomes tender, get it checked—those are warning signs. Doctors treat AKs as precancerous because a fraction may become invasive skin cancer over years.

Certain people are at higher risk: fair skin, lots of sun exposure through life, older adults, and anyone on immunosuppressant drugs. Tanning beds raise risk too. If you fit any of these, pay closer attention to new or changing spots.

Treatment options and what to expect

A dermatologist picks treatment based on how many lesions you have, their size, and where they sit. The most common quick fix is cryotherapy—freezing the spot with liquid nitrogen. It’s fast and often done in one visit, but the area may blister or scab for a week or two.

When you have multiple spots or a whole sun-damaged area, doctors use “field therapies.” Topical creams like 5-fluorouracil (5-FU), imiquimod, or diclofenac treat the whole field and can clear unseen micro-lesions. Expect redness, peeling, and irritation during treatment—those are signs it’s working. Photodynamic therapy (PDT) uses a light-activated drug and can treat larger areas with good cosmetic results.

Other options include curettage (scraping) and chemical peels for widespread thin lesions. If a spot looks suspicious, the doctor will biopsy it to rule out cancer. Follow-up matters—AKs can come back and new ones may appear.

Want simple self-care? Use a broad-spectrum sunscreen (SPF 30 or higher) every day, wear a wide-brim hat and sun-protective clothing, and avoid peak sun hours. Regularly check your skin and take photos of any odd spots so you can spot changes. Don’t pick or try to remove lesions yourself—see a professional.

If a patch grows, bleeds, or changes shape, book a skin check. Early detection keeps treatment simple and lowers cancer risk. Skin exams every year are a good idea if you’ve had AKs before.

Actinic keratosis is common and manageable. With sun-smart habits and regular checks, you can stop small sun-damaged spots from becoming a bigger worry.