Actinic keratosis: Signs and symptoms

Signs of actinic keratosis

The following photographs show signs of actinic keratoses (AKs).

If you see any of these signs on your own skin, you should see a dermatologist. Left untreated, AKs may turn into a type of skin cancer called squamous cell carcinoma. People who have AKs also have a higher risk of getting other types of skin cancer. When found early, most skin cancers can be cured.  

                Sun-damaged skin: This man does not have AKs, but his hand and wrist show signs of sun damage due to working outdoors most of his life. He has a higher risk of developing AKs on his hand and wrist.
                Scaly feeling on sun-damaged skin: You often feel an AK before you see it. This man felt a sandpaper-like patch on his sun-damaged neck before an AK appeared.
                Rough, reddish, raised bumps: Most AKs look like raised, scaly, red bumps on the skin. This 57-year-old woman has several AKs on her face.*
                Thick, discolored, scaly skin with many growths: Skin that soaks up years of sun, such as the scalp, face and arms can have many AKs. This man has thick growths on his forearm.**
                Brown patches: The AKs on this man's face appear as brown patches. When AKs look like this, they can resemble melanoma, a type of skin cancer.
                Horn: Some AKs grow quickly and look like an animal's horn. Horns are more likely to progress to skin cancer.***
                Whitish scale on bottom lip: When an AK forms on the lip, the AK is called actinic cheilitis. If you have a rough scaly lip, splitting lips or your lips always feel dry, you should see a dermatologist.
                Squamous cell carcinoma on lower lip: Without treatment, some AKs progress to squamous cell carcinoma, a type of skin cancer.

Symptoms of actinic keratoses

Most people who get AKs do not have any symptoms. They only notice changes to their skin. Symptoms can occur. A few symptoms to watch for are:

  • Rough-feeling patch on skin that cannot be seen.
  • Rough patch or growth that feels painful when rubbed.
  • Itching or burning.
  • Lips feel constantly dry.

Actinic keratosis: Now you see it, now you don’t

An AK can come and go. An AK can appear on the skin, remain for months, and then flake off and disappear. The skin can suddenly feel smooth. Many AKs re-appear in a few days to a few weeks. They often re-appear when the person goes outdoors without sun protection.

Even if an AK does not re-appear, you should see your dermatologist. AKs form when the top layer of skin is badly damaged. You can get more AKs. If the damage grows deeper, skin cancer can develop. 

Learn more about actinic keratosis:


Bhatia ND. “Medical Management of Actinic Keratoses.” Focus session presented at the 2011 American Academy of Dermatology Summer Academy Meeting: New York City. Aug 2011.

Moy RL. “Clinical presentation of actinic keratoses and squamous cell carcinoma.” J Am Acad Dermatol 2000 Jan; 42:S8-10.

Odom R. “Managing actinic keratoses with retinoids.” J Am Acad Dermatol 1998 Aug;39:S74-8.

Sander CA, Pfeiffer C, Kligman AM et al. “Chemotherapy for disseminated actinic keratoses with 5-fluorouracil and isotretinoin.” J Am Acad Dermatol 1997 Feb;36:236-8.

Photographs 1, 2, 5, 7, and 9 used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides. 

*Photograph used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol.1997;36:236-8.

**Photograph used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol.1998;39:S74-8. 

*** Photographs used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol 2000;42:S8-10.

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