What should you know about focal actinic keratosis?

Actinic keratosis, also called solar keratosis, develops after repeated ultraviolet exposure. It may feel gritty or sandpapery and can look pink, red, brown, or close to your usual skin tone. Common sites include the face, ears, scalp with thinning hair, forearms, and backs of the hands. A lesion can be easier to feel than see.

One spot does not describe every change on sun-exposed skin. A clinician may examine its surface and surrounding skin to distinguish it from irritation or another growth. Actinic keratosis is not the same as squamous cell carcinoma, but a changing or thick lesion may need closer assessment.

Arrange a skin examination, especially if the area is new, thickening, tender, bleeding, or not healing. Treatment depends on the spot, its location, your skin, and whether nearby areas also show sun damage. Options can include freezing the lesion, a prescribed cream such as imiquimod or topical 5-fluorouracil, or photodynamic therapy. Do not pick or file the surface.

Use broad-spectrum sun protection, seek shade, cover exposed skin, and avoid deliberate tanning. These habits reduce further ultraviolet exposure but do not replace assessment of an existing spot.

Book a prompt dermatology review when a rough spot becomes thicker, develops a firm raised area, repeatedly crusts, bleeds, hurts, or enlarges. Seek urgent medical help for bleeding that will not stop with gentle pressure or rapidly spreading redness around a lesion. A clinician may recommend a biopsy when the appearance is uncertain.

Ask whether the spot needs treatment or observation, what changes should trigger a return visit, and whether the rest of your sun-exposed skin should be checked. You can also ask how each option may affect healing, colour, texture, and daily activities.