Actinic keratoses

What are the aims of this leaflet?

This leaflet has been written to help you understand more about actinic keratoses. It describes what they are, what causes them to develop, how they can be treated and where you can find out more information.

What are actinic keratoses?

Actinic keratoses are areas of sun-damaged skin found predominantly on sun-exposed parts of the body, particularly the forearms, backs of the hands, face, ears, bald scalp and the lower legs. They may also occur on the lips. The terms actinic and solar are from the Greek and Latin respectively, meaning ‘sunlight-induced’. The term keratosis refers to thickened skin.

What causes actinic keratoses to develop?

They are caused by cumulative sun exposure over many years, from sunbathing, sunbed use, outdoor work or recreational activities. They are therefore more common in older people. Fair-skinned, blue-eyed, red- or blonde-haired individuals, who burn easily in the sun, are at particular risk. Actinic keratoses are not contagious.

What do actinic keratoses look and feel like?

Actinic keratoses can be variable in appearance but most often look like a change in colour or texture of a small patch of skin. At first, they may be hard to see, but can simply feel rough or scaly, looking like dry skin. They are often pink, but can be skin coloured or red. They can grow to a centimetre or two in diameter and occasionally develop a thicker warty layer. The surrounding skin often looks sun-damaged (blotchy, freckled and wrinkled).

They often do not cause any trouble, but can be itchy or sore. There is a very small risk that an actinic keratosis can progress into a form of skin cancer, called a squamous cell carcinoma. People with actinic keratoses are also at higher risk of developing other types of skin cancer, compared to someone of the same age without any actinic keratoses.

If an actinic keratosis develops into a lump, grows very quickly, becomes tender, forms an ulcer or starts to bleed, then medical advice should be sought as these changes could indicate the early onset of skin cancer (squamous cell carcinoma). People most at risk are those who have numerous patches of actinic keratosis and those on immunosuppressive drugs for accompanying conditions.

Are actinic keratoses hereditary?

No, but some of the risk factors for developing actinic keratoses do run in families – for example, a tendency to burn easily in the sun rather than tan (skin type), red or fair hair and freckling.

How are actinic keratoses diagnosed?

Usually the appearance of an actinic keratosis is sufficient to enable the diagnosis to be made by a doctor who manages skin problems, for example a GP or dermatologist. In cases of doubt, a sample (biopsy) or the whole affected area may be removed surgically under local anaesthetic for microscopic examination in the laboratory.

Can actinic keratoses be cured?

An individual actinic keratosis can be cured, but many return in future years. People who have developed one actinic keratosis are at risk of developing more in the future. In general terms, the tendency to get actinic keratoses is a long term problem.

How can actinic keratoses be treated?

Some actinic keratoses will resolve without treatment, especially if they are smaller and milder. Others will need treatment, and the choice of correct treatment can be discussed with your doctor. This will depend on the number and location of actinic keratoses, and other important factors which will differ between people.


Treatments that your doctor can provide for actinic keratoses:

How can I protect my skin?

Protecting your skin from the sun will help reduce the number of new actinic keratoses you get and will reduce the risk of developing a sun-induced skin cancer. You should be extra cautious in the sun by following these recommendations:

People who actively avoid sun exposure should have their vitamin D levels checked and monitored. You may be advised to take a vitamin D supplement by your GP.

Where can I find out more about actinic keratoses?


British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis

Web links for further information:

Published on:
October 31, 2023

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