Signs and Symptoms of Actinic Keratosis

Actinic keratosis is seen primarily on the face, ears, scalp, chest, and hands, although they can occur anywhere there has been excessive exposure to the sun.

The lesions are usually pink or skin colored and typically have a dry, overlying scale. Occasionally, the scale can be quite thick and appear as a hornlike projection. They are very rough and are often better detected by touch than by sight. Some lesions can become tender or sensitive. They tend to lose their top scaly layer and may appear to be healing; however, the scaly portion usually reforms.

Actinic keratosis on the lower lip presents as diffuse chapping that does not resolve, despite liberal use of petroleum jelly or lip balms.

When a lesion appears to be thickening into deeper layers of the skin, or when an ulcer develops, the possibility of malignant changes (skin cancer) exists.

Actinic Keratosis Diagnosis

Actinic keratosis is most often diagnosed clinically and treated accordingly. If skin cancer is suspected, a skin biopsy is obtained. The specimen (skin cells) is examined under a microscope to evaluate the damaged cells. If the cancerous cells fill the entire content of the epidermis, or if they extend beyond it, squamous cell carcinoma may be diagnosed.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 31 Aug 2000

Last Modified: 24 Aug 2015