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Telephone: 404-851-1766 Toll Free: 866-851-5030

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Patient Education

Actinic (Solar) Keratoses

Actinic or solar keratoses are precancerous lesions on the skin caused by chronic sun exposure. They present as rough scaly areas in sun-exposed areas of the body such as the face, nose, upper lip, ears, back of the neck, scalp, forearms, and backs of the hands. Actinic keratoses may be skin-colored to slightly pink / red in color. There may be yellowish or white scale along with crust. The lesions are often easier to feel than see and are raised above the skin surface. Occasionally, an actinic keratosis can have the appearance of a finger-like growth (cutaneous horn).


Actinic keratoses represent an area of abnormal skin cells due to damage from sunlight. They are most often seen in older people with fair complexion who tend to burn rather than tan and who have received a great deal of sun exposure over many years. Although some actinic keratoses clear by themselves, a few may progress over time to a form of skin cancer known as squamous cell carcinoma. However, it is not possible to predict the behavior of an individual lesion. In general, in patients with multiple (>8) actinic keratoses, there is about a 1 in 10 chance that one actinic keratosis will turn into a squamous cell carcinoma over a 10 year period. Treating actinic keratoses early can help to prevent this possibility.


Most actinic keratoses can be diagnosed by their clinical appearance. However, it may be difficult to distinguish some thick (hypertrophic) actinic keratoses from an early squamous cell carcinoma. A skin biopsy can help to differentiate these possibilities. Once an actinic keratosis is diagnosed, there are a number of treatment methods that may be used. The choice of treatment will depend on the number of lesions, their location, and their size and thickness. For people with a small number of actinic keratoses, spot treatment with liquid nitrogen (cryotherapy) is commonly used. This is a very cold liquid which destroys the abnormal skin tissue by freezing. When lesions are too numerous, other methods of treatment such as topical 5-fluorouracil cream or imiquimod cream may be preferable. These creams may cause irritation and redness where they are applied. Other types of treatment for widespread actinic keratoses include chemical peels,laser resurfacing, and dermabrasion which remove large areas of the affected skin surface. In addition, sun avoidance, sun protective clothing, and broad spectrum sunscreen are all key factors in decreasing the risk of developing further actinic keratoses in those susceptible.

logo-2 Finan Templeton Dermatopathology Associates 1200 Lake Hearn Drive, Suite 300     Atlanta, GA 30319     T: 404-851-1766