Conditions & Treatments

Actinic Keratosis

Actinic keratosis, also known as a solar keratosis, is a scaly or crusty bump that arises on the skin surface.

Actinic Keratosis

Actinic keratosis is a rough, scaly patch or bump on the skin. It’s also known as a solar keratosis. Actinic keratoses are very common, and many people have them. They are caused by ultraviolet (UV) damage to the skin. Some actinic keratoses can turn into squamous cell skin cancer. Because of this, the lesions are often called precancer. They are not life-threatening if they are found and treated early.

Risk factors for actinic keratoses

UV rays from the sun and from tanning beds cause almost all actinic keratoses. Damage to the skin from UV rays builds up over time. This means that even brief exposure to sun on a regular basis can build up over a lifetime and increase the risk of actinic keratoses. Some people are more at risk than others, including:

  • People with pale skin, blonde or red hair, and blue, green, or gray eyes

  • People with darker skin, hair, and eyes who have been exposed to UV rays without protection

  • Older adults

  • People with suppressed immune systems (due to chemotherapy, AIDS, organ transplant, or other causes)

  • People with rare conditions that make the skin very sensitive to UV rays, such as albinism or xeroderma pigmentosum (XP)

Signs of an actinic keratosis

An actinic keratosis develops slowly. It most likely appears on areas of skin often exposed to the sun. These can include such the face, ears, bald scalp, neck, backs of hands and forearms, and lips. It tends to lie flat against the skin of the head and neck, but appears as a bump on arms and hands. The base of an actinic keratosis may be light or dark, tan, pink, red, or a combination of these. Or it may be the same color as the skin. The scale or crust may be horny, dry, and rough. In some cases, it may itch or have a prickly or sore feeling.

Often, a person will have more than one actinic keratosis lesion. Actinic keratoses that develop on the lip are called actinic cheilitis.

How actinic keratosis is diagnosed

Health care providers can often diagnose an actinic keratosis by looking at and feeling the area on your skin. But sometimes an actinic keratosis can be hard to tell apart from skin cancer. Your health care provider might remove the area of skin to have it examined under a microscope. This is known as a skin biopsy.

How actinic keratosis is treated

Treatment for an actinic keratosis may include:

  • Freezing the lesion (cryotherapy)

  • Medicine applied to the skin (topical chemotherapy)

  • Minor surgery

  • Other treatments that remove or destroy the lesion      

Most actinic keratoses can be treated and cured. In rare cases they may come back. It’s important to have regular skin exams after treatment. This will help check for new actinic keratoses, and skin cancer.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

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Imaging

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    The Adult Medicine Imaging Program at Massachusetts General Hospital Imaging offers a wide range of diagnostic exams and minimally invasive, image-guided treatments, all provided using leading-edge equipment and interpreted by specialty-trained radiologists.
Department of Dermatology

  • The Medical Dermatology Program
    The Medical Dermatology program at Massachusetts General Hospital is a full-service dermatology practice that provides care for all skin, hair and nail conditions.
  • Khosrow Momtaz Phototherapy Center
    The Khosrow Momtaz Phototherapy Center at Massachusetts General Hospital has been at the forefront of ultraviolet radiation therapy for chronic skin conditions for more than 30 years.

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