Actinic Keratosis

Actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of exposure to the sun. Actinic Keratosis (AKs) is most commonly found on the face, lips, ears, back of your hands, forearms, scalp or neck — areas of skin typically exposed to the sun. AKs can vary in:

  • Color—they can be light, dark, tan, pink, red or even the same color as your skin
  • Size—from a pinhead to larger than a quarter
  • Appearance—from flat to slightly raised
  • Texture—smooth to rough, like sandpaper

Many doctors consider an Actinic Keratosis to be precancerous because it can develop into skin cancer. Therefore, Actinic Keratoses should be examined annually to rule out the possibility of early skin cancer. While AKs may give rise to skin cancers like squamous cell carcinomas, they do not turn into melanomas. AKs usually respond well to treatment.


  • Cryotherapy

    Cryotherapy (freezing) usually requires repeated treatments as liquid nitrogen only affects visible lesions. The dermatology provider applies liquid nitrogen, a very cold liquid, to the wart with a spray gun. This freezes the AKs. However, repeat treatments are often necessary.

  • Topicals

    A topical application of 5-fluorouracil (5 FU) cream is used to activate chemical peeling of the AKs. Continued application is required even when skin has been sensitized. This is a more difficult therapy for those with sensitive skin or people with an active outdoor lifestyle. Picato is also used to activate chemical peeling within as little as 2 days. Solarize is another choice that provides results within 3 months.

  • Photodynamic therapy (PDT)

    By using a special topical solution called Levulan that’s activated by light, abnormal cells are targeted and killed. Levulan is a “smart” solution. It is only absorbed by abnormal cells and usually requires 1 to 3 in-office treatments.

  • Immunotherapy

    AKs on the face and scalp can be treated by immunotherapy, which involves the application of a topical treatment with the active ingredient imiquimod — an immune enhancing agent that stimulates the body’s immune system to destroy precancerous cells.