Actinic Keratosis: An Overview for Patients and Caregivers

Actinic keratoses (AK) are rough, scaly skin lesions caused by cumulative sun damage. While benign, they can develop into squamous cell carcinoma, especially in people with weakened immune systems. Risk factors include fair skin, older age, male sex, high UV exposure, and immune suppression. AKs typically appear on sun-exposed areas such as the face, scalp, forearms, and hands, often feeling rough before they are easily visible. Diagnosis is made by clinical exam or biopsy if the lesion looks suspicious.

Treatment is important for all AKs since progression risk cannot be predicted. Options include lesion-directed therapies (cryotherapy, curettage, or excision) for isolated lesions, and field-directed therapies (topical creams like 5-FU, imiquimod, diclofenac, photodynamic therapy, chemical peels, or laser resurfacing) for widespread sun-damaged areas. Preventive strategies include sun protection and vitamin B3 (nicotinamide), which has been shown to reduce new AKs and nonmelanoma skin cancers. With early detection and treatment, outcomes are excellent.

Click below to download this resource.