Actinic Keratosis

Actinic Keratosis

One of the health risks of sun exposure, no matter what time of year or your skin type, is the formation of precancerous spots or lesions. Unfortunately, if these spots are left untreated, they are at a higher risk of developing into skin cancer. Actinic keratosis (AK) is a type of precancerous lesion that can lead to squamous cell carcinoma if not diagnosed and treated early.

At Nashville Skin, our board-certified dermatologists, Mohs surgeons, and dermatopathologist have the training and expertise necessary to provide accurate diagnoses and cutting-edge skin cancer treatment options for diverse skin issues, including precancerous spots like actinic keratosis.

What is Actinic Keratosis?

Actinic keratosis is also referred to as solar keratoses and most commonly appears in areas that receive excessive sun exposure, like the arms, hands, scalp, lips, and face. Actinic keratosis presents as a flaky, dry growth that can be brown or red. These patches may feel rough, like sandpaper and most closely resemble warts. With time, these patches of skin can quickly change to become thick, scaly or change colors. Because actinic keratosis grows quickly, there is a risk of the lesion becoming cancerous in a short amount of time.

There are certain risks that increase a person’s chance of developing AK. These factors include:

  • Excessive sun exposure
  • Tanning bed use, even once!
  • Fair-skinned complexion
  • Over the age of 50

Due to the aggressive nature of these types of growths, it’s important to have any suspicious spots examined by one of Nashville Skin’s dermatology experts as soon as possible. If the lesion is precancerous it can become squamous cell carcinoma without proper treatment from a board-certified dermatologist.

Treating Actinic Keratosis

In order to accurately treat actinic keratosis, our dermatologists may take a skin biopsy to test for skin cancer. If determined to be precancerous, it can be treated with one of a combination of the following options:


A study published in The Journal of Clinical Investigation found that the use of topical drugs like Imiquimod triggers the immune system and aids the body in fighting the abnormal cells in precancerous spots.


Cryosurgery is an innovative technique that can quickly remove the AK lesion with minimal scarring. With this technique, liquid nitrogen is applied to the spot long enough to freeze the affected skin. As a result, a blister is created underneath the treated area. Once new skin forms underneath the blister, the precancerous skin will shrink, blister or peel off. A cryotherapy treatment is fast and effective, with minimal side effects like redness, swelling or pigmentation loss associated with other more invasive procedures.

Topical Medication

Topical medications, such as 5-fluorouracil (Carac, Fluoroplex, or Efudex), Ingenol mebutate gel (Picato), Diclofenac gel (Voltaren, Solaraze) or Imiquimod cream (Aldara, Zyclara), target and destroy any precancerous cells in the treated area. These FDA approved medications are applied once or twice a day for several weeks. With 5-fluorouracil, the pre-cancerous spots gradually disappear with little-to-no scarring.

Photodynamic Therapy

Photodynamic therapy is an advanced treatment for precancerous and cancerous lesions. In a photodynamic therapy treatment, our practitioners use a drug called Aminolevulinic acid, which is placed on the skin in the affected area. Then, a special blue light is used to activate the drug and eliminate the abnormal cells. Photodynamic therapy is a great option for patients because it’s quick and non-invasive with minimal possible side effects.

Tips for Preventing Actinic Keratosis

Since sun exposure is the biggest risk for developing AK as well as the various forms of skin cancer, including basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. It’s important to take precautions to protect yourself from the dangerous UV rays and overexposure.

The best ways to prevent overexposure are:

  • Avoid the sun during peak daylight hours (between 10 am to 3 pm)
  • Avoid sunburns
  • Do not use UV tanning beds
  • Wear sun-protective shirts, hats, and pants
  • Apply SPF 30 (minimum) UVA/UVB sunscreen for short periods of activity outside
  • Apply SPF 30-50 (minimum) UVA/UVB sunscreen for prolonged activity outside
  • Reapply sunscreen when doing activities like swimming
  • Check your skin at least once a month
  • See our staff at Nashville Skin for yearly professional skin exams

Actinic Keratosis Treatments Available in Nashville

If you think you have an actinic keratosis, contact us today at one of our convenient Nashville locations (21st Avenue S., Southern Hills Medical Center, Centennial Medical Center and St. Thomas Medical Center – Lennox Village), or our Clarksville office to schedule a formal evaluation with one of our practitioners for a pre-cancer screening, diagnosis, and full explanation of treatment options.

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