What it is
Actinic keratosis is a rough, dry or scaly patch that often shows up on skin that has had a lot of sun over the years, such as the face, ears, scalp, hands and forearms. Some feel like sandpaper before they are easy to see. They can be flat or slightly raised, and may be pink, red, tan or skin-colored.
Clinicians generally consider AKs precancerous, meaning some can change over time into a type of skin cancer. That does not mean every spot will. It is the reason these patches are worth showing to a professional rather than ignoring or guessing.
Because AKs can resemble warts, irritated skin, or other growths, they are easy to mistake for something harmless. Warts.ai cannot tell you what a spot is. Only a licensed clinician, usually a dermatologist, can examine it and decide.
How it’s traditionally been approached
Evaluation usually starts with a clinician looking closely at the skin, sometimes with a handheld magnifying device. They may ask about sun history, how long the spot has been there, and whether it has changed. If something looks unusual, a clinician may recommend a skin biopsy to learn more.
Approaches to AKs have traditionally included treating individual spots, such as with cryotherapy (freezing), and treating a wider area of sun-damaged skin, often called field treatment, using prescription creams or other in-office methods. Which approach, if any, is used is a clinician's decision after an exam.
Follow-up is a common part of care, since sun-damaged skin can develop new spots. Many clinicians also talk about sun protection and regular skin checks. Results vary, and spots can come back or new ones can appear.
How the right provider may help
A dermatologist or other qualified clinician may help by examining your skin, telling you whether a spot looks like an AK or something else, and explaining the options that fit your situation. They can also check areas you can't easily see, such as the scalp or back of the neck.
A visit generally involves a conversation about your history, a skin exam, and, if needed, a discussion of whether a biopsy or treatment makes sense. Questions you might bring: What do you think this spot is? Does it need a biopsy? What are the options and what is the healing like? How often should I come back for skin checks?
If you have diabetes, a weakened immune system, or take medicines that affect your skin or immunity, mention it. Ask your provider about the current FDA status of any prescription product they suggest. You can also use Providers.plus to find licensed providers.
The whole-person view
Body, mind and stress affect each other. Worry about a changing spot can be hard to carry, and stress can make it easier to put off an appointment. Being kind to yourself, and remembering that checking a spot is a practical step, can make the process feel more manageable.
If health worries feel heavy, body-based support such as Somatic Experiences may help some people feel more settled, and talk therapy through Therapists.plus may help others work through anxiety. These are complements to, not replacements for, care from a licensed clinician.
Somatic Experiences: nervous system regulation →Therapists.plus: anxiety panic and ocd →
Keep in mind
- A spot that is changing, bleeding, itching, irregular in shape or color, or not healing should be checked by a dermatologist for skin cancer, and should not be self-treated.
- The ABCDEs of melanoma (asymmetry, border, color, diameter, evolving) are only a general guide to why checks matter, not a way to diagnose yourself.
- Do not cut, burn, scrape or dig out a spot at home, and do not use over-the-counter wart products on a rough patch, especially on the face, since it may not be a wart.
- Licensed professionals should guide care. For emergencies call 911; if you are in crisis call or text 988.
Actinic keratoses are considered precancerous — always a clinician's call.
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Frequently asked questions
What is actinic keratosis?
Actinic keratosis is a rough, scaly patch of skin that develops from long-term sun exposure and is considered precancerous by clinicians. It often appears on the face, scalp, ears, hands and forearms. A licensed clinician must examine a spot to know what it is.
Is actinic keratosis the same as a wart?
No, actinic keratosis is not a wart, though the two can look alike. AKs are linked to sun damage, while warts are caused by a virus. Because they can be confused, a clinician should look at any rough spot rather than guessing.
Is actinic keratosis cancer?
Actinic keratosis is not considered skin cancer itself, but it is regarded as precancerous because some spots can progress. Only a clinician can tell whether a spot is an AK or something more serious, sometimes with a biopsy. Any spot that changes, bleeds or does not heal should be checked promptly.
How is actinic keratosis traditionally treated?
Clinicians have traditionally treated individual spots with methods such as cryotherapy, and wider sun-damaged areas with field treatment. Whether any approach is right for you is a clinician's decision after an exam. Results vary, and new spots can appear.
Can I treat a rough scaly patch at home?
No, you should not treat a rough scaly patch at home until a clinician has looked at it. It may not be a wart, and over-the-counter wart products are not meant for this. Never cut, burn or dig out a growth.
Who should I see for a rough scaly patch or sun-damaged skin?
A dermatologist is the usual choice for evaluating a rough scaly patch or sun-damaged skin. A primary care clinician can also take a first look and refer you. You can search Providers.plus to find licensed providers.
Educational resource. Warts.ai shares general information and connects people with independent providers. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.