Actinic keratosis (AK), also known as solar keratosis, is one of the most common skin lesions we treat at Denver Dermatology Center.

AKs are pre-cancerous lesions that look like rough, red, scaly, raised patches of skin usually found in sun-exposed areas on the scalp, face, ears, forearms, and hands. Patients often first notice these lesions because they look abnormal or feel strange to the touch. Because most of us cannot determine whether a scaly patch is an actinic keratosis or simply dry, rough skin, we recommend visiting a board-certified dermatologist for the correct diagnosis and, if necessary, a customized treatment plan. 

FAQs About Actinic Keratosis

When I examine my skin for AK lesions, what should I be looking for?

Most actinic keratoses are found on areas of the body that have seen regular exposure to the sun, including your scalp, face, ears, neck, forearms, hands, or even calves. AKs are typically scaly, red, rough, and raised.

Some actinic keratoses resemble warts and can itch, burn, or bleed, especially when scratched. Their color can vary widely, from white to pale pink, brown, or red. Because most individuals cannot differentiate between cancerous and non-cancerous spots, we recommend that a dermatologist evaluate any suspicious areas. Our team can easily identify most lesions with a visual inspection, though a biopsy may be necessary. 

What causes actinic keratosis?

Years of regular sun exposure or even a short period of intense exposure, including tanning bed use, can lead to the development of an actinic keratosis. 

Are some people more likely to develop pre-cancerous lesions?

Actinic keratosis is more common in people who are over 40, have pale or freckly skin, light hair or eyes, and sunburn easily. Similarly, people who live in a sunny climate and have been exposed to intense sun exposure from work, sports, or recreation often develop solar keratoses on exposed areas of skin. This condition is also more common in individuals with a weakened immune system.

If I have actinic keratosis, will it develop into skin cancer?

A percentage of lesions identified as an actinic keratosis develop into squamous cell carcinoma. Removing an actinic keratosis early enough can prevent the development of this type of skin cancer.

What are the most common treatments for removing actinic keratoses?

Your actinic keratosis treatment will depend on the extent of your lesions. If you have one or two, we will likely recommend removing each one individually. The most common removal method is cryotherapy, in which a very cold substance, liquid nitrogen, is applied to each lesion, causing it to blister, peel, and eventually heal with new skin. Cryotherapy is performed quickly, with minimal pain, as an in-office procedure.

If you have several actinic keratoses, your treatment may involve the daily or twice daily application of a topical prescription cream. These medications work by selectively targeting and destroying unhealthy skin cells so that new, healthy ones can emerge in their place. 

For some patients, we recommend Intense Pulsed Light Photodynamic Therapy (IPL-PDT) or BLU-U-PDT. These procedures involve the use of a topical agent with IPL and/or natural light to treat sun damage and help prevent the development of skin cancer. Just one treatment can greatly reduce or eliminate precancerous lesions while improving the skin’s tone and texture. Photodynamic Therapy can be performed on the face, neck, chest, back, arms, and hands. While some insurances cover BLU-U-PDT, IPL-PDT is considered a cosmetic procedure.

How can I reduce my risk of developing an actinic keratosis?

You can reduce your risk of developing solar keratoses by protecting your skin from ultraviolet rays. Apply high-SPF sunscreen and reapply it regularly, wear sun-protective clothing and hats, and, whenever possible, stay out of the sun between 11:00 a.m. and 1:00 p.m., when the sun’s rays are strongest.

Our team has years of training and experience in helping patients identify and treat cancerous or pre-cancerous lesions. For cosmetic photodamage, including spots and skin imperfections, we offer highly effective treatments and procedures to help our patients obtain and maintain healthy, radiant skin.