About Actinic Keratosis
Actinic keratoses (AKs) are rough, scaly spots caused by long-term sun damage. They are considered pre-cancerous because a portion of untreated AKs may progress over time into squamous cell carcinoma, a type of skin cancer. AKs are most common on sun-exposed areas: the scalp (especially in those with thinning hair), face, ears, lips, neck, forearms, and backs of the hands.
Because AKs typically reflect broader underlying sun damage, treatment often combines targeting individual spots with "field therapy" to address pre-cancerous changes across an entire area.
Symptoms & signs to watch for
Common signs that may suggest actinic keratosis include:
- Rough, scaly, sandpaper-textured spots on sun-exposed skin
- Pink, red, brown, or skin-colored patches
- Spots that come and go but never fully heal
- Itching, burning, or tenderness in affected areas
- Multiple lesions clustered on the scalp, face, ears, or hands
- Cracked, dry, or scaly patches on the lower lip (actinic cheilitis)
Treatment approach
Treating actinic keratoses lowers the risk of progression to squamous cell carcinoma. Treatment choice depends on the number, location, and thickness of the spots, and on your overall skin health and tolerance for downtime.
Treatment options your provider may discuss:
- Cryotherapy (liquid nitrogen) for individual lesions
- Topical field therapies (e.g., 5-fluorouracil, imiquimod, tirbanibulin)
- Photodynamic therapy (PDT) referrals where appropriate
- Curettage or shave removal for thicker, suspicious lesions
- Biopsy if any lesion looks suspicious for skin cancer
- Long-term sun protection, skin-exam, and prevention counseling
Not every option is appropriate for every patient. Your dermatology provider will recommend a treatment plan based on your individual evaluation.
When to see a dermatologist
Schedule an evaluation if you have rough, scaly spots on sun-exposed skin that don't heal, especially on the scalp, face, ears, or hands. Treating actinic keratoses early may help prevent skin cancer.
Available at our Alaska clinics
Care for actinic keratosis is offered through Advanced Dermatology of Alaska. Specific procedure availability may vary by clinic. Please call to confirm before scheduling.
Wasilla Clinic
3066 E Meridian Park Loop
Wasilla clinic details →
Wasilla, AK 99654Anchorage Clinic
1100 E Dimond Blvd
Anchorage clinic details →
Anchorage, AK 99515Juneau Clinic
3268 Hospital Drive
Juneau clinic details →
Juneau, AK 99801
Medical disclaimer
This page is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call 911 or go to the nearest emergency department.
