What is actinic keratosis?

Actinic keratosis, also called solar keratosis, is a skin growth that develops in sun-exposed skin. The growth often happens on the face, hands, forearms, and neck. It occurs most often in people with lighter skin.

Actinic keratoses are small and noticeable red, brown, or skin-colored patches that don't go away. They most often occur on the head, neck, or hands but can be found on other areas of the body. Usually more than one is present. They may:

• Have a rough texture.
• Itch, burn, or sting.
• Range in size from 1 mm (about the size of the tip of a pencil) to 2 cm or larger (about the size of a peanut).
• Be numerous, with several patches close together.
• Be surrounded by red, irritated skin.

Actinic keratosis needs to be checked by a doctor, especially if the keratoses become painful, bleed, become open sores, become infected, or increase in size.

Actinic keratosis is diagnosed through a skin exam. Your doctor may use a bright light or magnifying lens to look for growths, moles, or lesions. The scalp is checked by parting the hair. If there is a chance of cancer, your doctor may take a sample of your skin and test (biopsy) it.

Your doctor may recommend one of these treatments:

• Cryotherapy. This involves freezing the skin growth with liquid nitrogen. There is little or no scarring. Cryotherapy can make the treated skin a lighter color than the nearby skin (hypopigmentation). This color change may not go away.
• Medicines put on the skin (topical therapy). These include medicines like fluorouracil cream, imiquimod cream, and tirbanibulin ointment.
• Curettage. Treatment involves shaving the growth using a spoon-shaped instrument (curette). After shaving, electrodesiccation may be done to control bleeding and destroy any abnormal cells that remain. Curettage is a quick treatment, but there may be some scarring. There may also be changes in the color (pigment) of your skin.
• Photodynamic therapy (PDT). This uses medicine, such as aminolevulinic acid (ALA), that is put on the skin and then activated with light. The light causes the medicine to destroy the actinic keratosis.
• Chemical peels. Chemicals are applied to destroy the top layer of skin. This is done so new skin can grow and replace damaged skin.
• Laser resurfacing. An intense beam of light from a laser (such as the carbon dioxide laser) is used to destroy the top layer of skin. As the treated area heals, new skin grows to replace the damaged skin.

• If your doctor told you how to care for the treated area, follow your doctor's instructions. If you did not get instructions, follow this general advice:
  • Wash around the area with clean water 2 times a day. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may cover the area with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
  • Apply more petroleum jelly, and replace the bandage as needed.
  • Avoid using an antibiotic ointment unless your doctor recommends it.