Home  /  Skin Cancer Information  /  Actinic Keratosis (Solar Keratosis)

Patient Education

Actinic Keratosis (Solar Keratosis)

The rough, scaly sun spots that Australians commonly develop — what they are, why dermatologists treat them early, and the field therapies available including PDT.

Actinic keratosis (AK) — also called solar keratosis — is one of the most common reasons Australians visit a skin clinic. These rough, scaly patches are caused by years of UV exposure and are considered pre-cancerous: a small proportion can progress to squamous cell carcinoma if left untreated. The vast majority can be managed easily when caught early.

What Does Actinic Keratosis Look Like?

  • Rough, sandpaper-like patches — often easier to feel than to see
  • Red, pink or skin-coloured, sometimes with a adherent scale or crust
  • Common sites: face, balding scalp, ears, forearms and backs of hands
  • Usually multiple — where there is one, there are often several ("field change")
  • More common after age 40, in outdoor workers, and in fair skin

The 4-week rule: any scaly or crusted spot that persists beyond about 4 weeks — or that grows, thickens, becomes tender or bleeds — should be professionally assessed.

Why Treat AKs Early?

Most AKs will never become cancer, but a small percentage progress to squamous cell carcinoma (SCC) over time. Because nobody can reliably predict which ones will progress, dermatology practice is to treat visible AKs and reduce the overall "field" of sun damage — particularly on the face and scalp.

Treatment Options

  • Cryotherapy — freezing individual spots; quick and effective for isolated lesions
  • Field photodynamic therapy (PDT) — a light-activated treatment that treats an entire sun-damaged area (for example the whole face or scalp) in one session, targeting both visible lesions and early sub-clinical change
  • Topical field treatments — prescription creams used over several weeks for suitable patients

The right option depends on how many lesions there are, where they are, your skin type, and your schedule. At your consultation the doctor will examine the whole sun-damaged area — not just the spot you noticed.

Prevention After Treatment

  • Daily broad-spectrum SPF 50+ sunscreen — even in winter, even on cloudy days
  • Wide-brimmed hats and shade for outdoor time
  • Regular skin checks — AKs tend to recur in sun-damaged skin, and new ones are easier to treat early

This page provides general educational information only. It is not a diagnosis and does not replace individual medical advice. If you are concerned about a lesion, please book a professional skin assessment.

Related Information & Services

Concerned about a spot or lesion?

Skin Cancer Laser Centre, Drummoyne — opening Monday 2 November 2026. Book a professional skin check with our doctors.

BOOK A SKIN CHECK