Can actinic keratosis cause squamous cell skin cancer?

Actinic keratoses develop in skin damaged by ultraviolet radiation. They are treated as precancerous changes because abnormal keratinocytes can remain superficial or acquire changes that allow growth deeper into the skin.

An actinic keratosis often feels rough or scaly and commonly appears on sun-exposed areas such as the face, scalp, ears, forearms or backs of the hands. Squamous cell skin cancer can arise within an existing lesion or elsewhere in a field of sun-damaged skin.

A clinician cannot reliably identify future progression from texture or colour alone. Examination may be enough for a typical lesion, while a biopsy can distinguish cancer when the area is thick, tender, ulcerated, enlarging or otherwise atypical.

Arrange a skin assessment for a new persistent rough patch or a known actinic keratosis that changes. Depending on the number, site and thickness of lesions, treatment may target one spot or a broader sun-damaged area. Options can include freezing, a prescribed skin medicine, light-based therapy, scraping or removal.

Protect exposed skin with shade, clothing, a hat and broad-spectrum sunscreen, and avoid intentional tanning. Check familiar areas regularly so you can report a change rather than trying to diagnose it from photographs.

Book a prompt clinical review if a patch grows noticeably, becomes a firm lump, repeatedly bleeds, develops an open sore, becomes increasingly painful or returns after treatment. Seek urgent care for bleeding that will not stop with firm pressure or for spreading redness, fever and discharge after a skin procedure.

Ask whether the area has typical features of actinic keratosis, whether biopsy is needed, and whether treatment should cover a single lesion or a wider field. Also discuss how to care for the site after treatment and which future changes should bring you back sooner.