Actinic keratosis (AK), also known as a solar keratosis, is a small, rough spot occurring on skin that has been chronically exposed to the sun. Actinic keratoses generally measure in size between 2 to 6 millimeters in diameter (between the size of a pencil point to that of an eraser). They are usually reddish in color and often have a white scale on top.

Causes of Actinic Keratosis

Repeated, prolonged sun exposure causes skin damage which may develop into a solar keratosis.
The sun damage responsible for a solar keratosis usually occurred years before the lesion forms.
A history of frequent or intense sun exposure or sunburn.
Pale skin.
Blond or red hair, especially when coupled with blue, hazel or green eyes.
A tendency to freckle or burn when exposed to sunlight.
A weak immune system as a result of chemotherapy, AIDS or an organ transplant.
Common locations for actinic keratoses are the face, scalp, back of the neck, upper chest, as well as the tops of the hands and forearms.
Men are more likely to develop AKs on top of the ears, whereas women's hairstyles often protect this area.

Treatment of Actinic Keratosis

Freezing (cryotherapy) - An extremely cold substance, such as liquid nitrogen, is applied to skin lesions. The substance freezes the skin surface, causing blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. This is the most common treatment, takes only a few minutes, and can be performed in your doctor's office.
Creams or ointments - Some topical medications contain fluorouracil, a chemotherapy drug. The medication destroys actinic keratosis cells by blocking essential cellular functions within them.
Chemical peeling - This involves applying one or more chemical solutions — trichloroacetic acid (TCA), for example — to the lesions. The chemicals cause your skin to blister and eventually peel, allowing new skin to form. This procedure may not be covered by insurance, because it's considered cosmetic.
Solar keratoses can be removed by surgery or by freezing with Liquid nitrogen.
When there are many keratoses, a useful treatment is 5-FU (5-fluorouracil) cream.

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