Actinic Keratosis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Actinic Keratosis?
A dermatologist (a skin doctor) usually diagnoses and treats actinic keratosis. A primary care doctor can also check rough or scaly spots and refer you to a skin doctor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is actinic keratosis?
Actinic keratosis (AK), also called solar keratosis, is a small, rough, raised area on the skin. This precancerous growth is caused by the sun or indoor tanning, and it often appears on skin exposed to the sun over a long period of time.
A small number of these skin growths turn into squamous cell carcinoma, a type of skin cancer. AK is one of the most common skin conditions that dermatologists treat. More than 40 million Americans develop AKs each year.
Symptoms
Actinic keratosis is usually found on the face, scalp, back of the hands, chest, or other places often in the sun. On the lips it is called actinic cheilitis (a precancerous growth on the lip) and can look like a badly chapped lip.
Skin changes to watch for include:
- Flat, scaly areas that often have a white or yellow crusty scale on top.
- Growths that may be gray, pink, red, or the same color as your skin.
- Spots that later become hard and wart-like, or gritty and rough.
- Areas that are easier to feel than to see. Some AKs look like a new age spot, a pimple, or a patch of irritated skin.
Causes and who gets it
Actinic keratosis is caused by exposure to sunlight. Over the years, sun damage builds up and can cause precancerous changes in the skin. Tanning beds and sunlamps also cause AKs. The harmful radiation from a tanning bed is similar to the sun and may be stronger.
You are more likely to develop AK if you:
- Have fair skin, blue or green eyes, or blond or red hair.
- Spend a lot of time in the sun, such as outdoor work.
- Had many severe sunburns early in life.
- Are older.
- Had a kidney or other organ transplant, or take medicines that suppress the immune system.
How doctors diagnose it
A dermatologist can often diagnose AK by looking carefully at your skin. While examining your skin, the doctor also looks for signs of skin cancer. A skin biopsy (removing a small piece of skin for testing) may be done to see if a spot is cancer.
Treatment
If you have one or more AKs, a doctor will talk with you about treatment. Usually, treatment is recommended. For one or a few AKs, an office procedure may be best. For several AKs, medicine used at home may be recommended.
Procedures include:
- Cryosurgery: the doctor freezes the AK with a very cold substance like liquid nitrogen. The goal is for it to fall off after a few days. Crusting or a blister afterward is normal.
- Curettage: the doctor scrapes off a very thick AK and may use electricity to destroy any remaining cells.
- Photodynamic therapy: a solution that makes the skin extremely sensitive to light is applied, followed by a blue or red light that can destroy the AKs. For 48 hours after treatment, avoid being outdoors in daylight, because even cloudy-day UV light can cause a serious skin reaction.
- A medical-grade chemical peel can destroy the top layers of skin.
At-home medicines are approved by the FDA to treat AKs. They treat many AKs, including ones you cannot see yet, and may lower the risk of new AKs and possibly skin cancer. These include 5-fluorouracil (5-FU) cream, imiquimod cream, diclofenac sodium gel, and tirbanibulin ointment. 5-FU is not an option for a woman who is pregnant. This medicine can harm an unborn baby. Never apply hydrocortisone or another corticosteroid to treated skin, because it stops the treatment from working.
When to see a doctor
Have your doctor look at any rough or scaly spot as soon as you find it. See a doctor right away if you notice any other skin change. A small number of these growths turn into squamous cell carcinoma, a type of skin cancer. When found early and treated, skin cancer is highly treatable.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. This doctor can check your skin at regular visits and refer you to a dermatologist when needed. The doctor can also help with sun protection habits that lower your risk.
Common questions
Is actinic keratosis contagious?
No, it is not contagious. Actinic keratosis is a precancerous skin growth caused by the sun or indoor tanning.
Can actinic keratosis turn into cancer?
Some actinic keratoses may develop into squamous cell carcinoma, a type of skin cancer. A small number of these skin growths turn into this cancer. When found early and treated, skin cancer is highly treatable.
How is actinic keratosis treated?
For one or a few spots, a doctor may freeze or scrape them off during an office visit. For several spots, prescription creams like 5-FU or imiquimod may be used at home.
How can I lower my risk?
Protect your skin from sun and ultraviolet (UV) light. Wear hats and long sleeves, avoid midday sun, use a broad-spectrum sunscreen with an SPF of at least 30, and reapply it often. Avoid tanning beds and sunlamps.
Sources
- MedlinePlus - Actinic keratosis
- American Academy of Dermatology Association - Actinic keratosis: Overview
- American Academy of Dermatology Association - Actinic keratosis: Diagnosis and treatment
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
