What should you know about small actinic keratosis?

Actinic keratosis, also called solar keratosis, develops in skin that has received substantial ultraviolet exposure. It may feel gritty or scaly and can look pink, red, tan, or close to your natural skin tone. Common sites include the face, ears, scalp, forearms, and backs of the hands. A small lesion may be easier to feel than see. It is not the same as a confirmed skin cancer, but some lesions can change over time, so a clinician may examine it with magnification and decide whether testing is needed.

Arrange a routine skin assessment, especially if the spot is new, persistent, rough, tender, or changing. Do not pick or scrape it. Use broad-spectrum sun protection, protective clothing, and shade; these habits also help limit further sun-damaged skin. Treatment depends on the number, thickness, location, and appearance of lesions. Options may include cryotherapy, a prescribed cream such as imiquimod or topical 5-fluorouracil, or photodynamic therapy. A clinician can explain expected redness, crusting, or irritation after treatment.

Contact a dermatologist promptly if the area grows quickly, becomes persistently painful, bleeds, forms an ulcer, develops a firm thickened center, or fails to heal. Seek assessment for any nearby new or changing spots as well. These changes do not establish a diagnosis, but they warrant direct examination because actinic keratosis can resemble, or sometimes progress toward, squamous cell carcinoma.

Ask: Does this look like actinic keratosis or another lesion? Do I need a biopsy? Which treatment fits its location and thickness? How should I care for the skin while it heals? When should the area be rechecked?