Actinic keratoses (AK), also known as solar keratoses, are common crusted skin lesions caused by chronic sun exposure. Up to 60 % of all people over 40 years of age in the Northern hemisphere develop actinic keratoses.
Actinic keratoses arise in keratinocytes, cells that make up the upper layer of the skin. AKs can be the first step leading to squamous cell carcinoma. About 2-10% of these squamous cell caricnomas can spread internally and are life-threatening.
Actinic keratoses are usually multiple, flat or slightly elevated pink, red, brown or tan-colored skin lesions that have the feel of sandpaper. They occur on areas of the skin chronically exposed to sun light, such as the face, ears, neck, forearms, lower legs and backs of hands.
Patients often complain that these lesions are sensitive or they sting or burn.
Who gets actinic keratoses?
The likelihood of developing AK increases when you have one or more of the following risk factors:
Gender
Men are more likely to develop AK because they tend to spend more time in the sun
History of extensive sun exposure
History of indoor tanning
Personal or family history of skin cancer
Age
Older people are more likely to develop AK, most likely due to total amount of previous sun exposure.
Fair skin
Light-colored hair
Light-colored eyes
Freckling
Sun sensitivity
Rare genetic disorders, such as albinism and xeroderma pigmentosum
What causes actinic keratoses?
Actinic keratoses are caused by chronic, high-level exposure to sunlight and other forms of UV radiation, such as tanning beds and certain ultraviolet light treatments.
What does an actinic keratosis look like?
Actinic keratoses are usually multiple, flat or slightly elevated pink, red, brown or tan-colored crusted or rough skin lesions on areas of the skin chronically exposed to sun light, such as the face, ears, neck, forearms, lower legs and backs of hands. Lesions develop slowly. They may disappear and then appear again. Some AK can bleed.
How are actinic keratoses diagnosed?
Usually AKs are diagnosed by clinical examination. If a lesion looks suspicious for already having developed into a squamous cell carcinoma, then a skin biopsy will be performed.
Other methods include Solaraze gel, tretinoin, laser treatment, and curettage and electrodesiccation.
Prevention of actinic keratoses
Avoid sun exposure between the hours of 10 am and 4 pm
Use a broad-spectrum sunscreen with excellent UVB and UVA coverage.
Apply the sunscreen at least 20 minutes before going outside
Reapply sunscreen every two hours or more often if swimming or sweating
Wear sun-protective clothing, a wide-brimmed hat and sunglasses
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Actinic keratoses (AK), also known as solar keratoses, are common crusted skin lesions caused by chronic sun exposure. Up to 60 % of all people over 40 years of age in the Northern hemisphere develop actinic keratoses. 
