What should you know about pigmented actinic keratosis treatment?

Actinic keratosis develops in skin damaged by repeated ultraviolet exposure. It may feel rough, dry or gritty and can be tan, brown, pink or red. Pigment can make it look like a freckle or mole, so a visual check alone may not settle the diagnosis. A dermatologist may use [Skin Cancer Screening](/treatments/diagnostics-and-testing/skin-cancer-screening/) and sometimes sample tissue. The purpose is to distinguish it from an established skin cancer such as [Squamous Cell Carcinoma](/conditions/squamous-cell-carcinoma/).

Treatment depends on the lesion’s size, thickness, location, number of spots and examination findings. Options may include freezing with [Cryotherapy (Lesion Removal)](/treatments/surgical-dermatology/cryotherapy-lesion-removal/), a prescribed field treatment such as [Imiquimod Treatment](/treatments/medical-dermatology/imiquimod-therapy/) or [Topical 5-Fluorouracil](/treatments/medical-dermatology/topical-5-fluorouracil/), or light-activated [Photodynamic Therapy](/treatments/laser-and-energy/photodynamic-therapy/). These can cause redness, tenderness, crusting or temporary colour change. Protect treated and untreated skin from ultraviolet exposure and follow the planned review schedule.

Book a dermatology appointment for a new rough pigmented spot or one that changes in size, shape or colour. Seek prompt review if it bleeds, becomes tender, forms a persistent crust or fails to heal. Do not repeatedly scrape or self-treat a lesion before it has been examined, because this can obscure useful surface features.

Does this lesion need dermoscopic examination or a biopsy? Which treatment fits its thickness and location? What reaction should I expect, and how should I care for the area? When should the spot be checked again?