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Actinic Keratosis

Actinic keratosis (AK)

Actinic keratoses (AKs) — also called solar keratoses — are rough, scaly sunspots caused by long-term UV exposure. They’re extremely common in Australia, especially on the face, scalp, ears, forearms and backs of hands.

AK is not usually dangerous in the short term, but it matters for two reasons:

1.An AK can progress to squamous cell carcinoma (SCC) in some cases, and

2.Multiple AKs are a sign of “field” sun damage — meaning the surrounding skin has a higher baseline risk of developing further AKs and skin cancers over time.

This page is a hub. Use it to understand what AK is, then go deeper into:

  • what AK looks like and why it forms, and
  • the best treatment pathways to reduce your future risk.

[Book a targeted spot check (1–3 spots)]
 [Book a full skin check] 

Quick links

The 30-second overview

What is an actinic keratosis?

A sun-damaged patch where the skin cells have become abnormal. It often feels like sandpaper and can look pink, red, skin-coloured, or brown.

Is it skin cancer?

AK is a pre-cancer. Many AKs stay stable or come and go, but a proportion can progress to SCC, especially if they become thicker or tender.

Why do doctors talk about “field damage”?

If you have multiple AKs, the skin around them has usually had years of UV exposure — so we often treat the whole zone (not just one spot) to reduce the overall burden and future risk.

When should I get an AK checked urgently?

Book an assessment sooner if an AK is:

  • becoming thicker, more raised or lump-like
  • tender, painful, or persistently itchy
  • bleeding, crusting repeatedly, or ulcerating
  • growing quickly
  • on a high-risk site (lip, ear, scalp in a bald area)

These features can suggest progression towards SCC or another diagnosis that needs treatment.

[Book a targeted spot check (1–3 spots)] 

How we approach AK at The Skin Doctor

AK management isn’t just “freeze the spot.” The best strategy depends on whether you have:

  • a single AK (often suitable for targeted treatment), or
  • multiple AKs / widespread sun damage (often best managed with a “field treatment” plan)

If you’re the patient who keeps getting “sunspots” every few months, it’s usually a sign you need a longer-term plan — not just repeated one-off treatments.

[Learn about AK treatment pathways]

Explore actinic keratosis in detail

Actinic keratosis: explanation (what it is, what it looks like, what it means)

If you’re trying to work out whether your spot is an AK and what it implies about your skin cancer risk, start here.
 [Actinic keratosis information] (HL91)

Actinic keratosis treatment (reducing the burden of sun damage)

If you already know you have AKs and want to understand treatment choices — including when “field therapy” is the smarter approach — go here.
 [Actinic keratosis treatment] 

Not sure what to book?

FAQ

Are actinic keratoses the same as sunspots (freckles)?

No. Freckles and sunspots (lentigines) are pigment changes. AK is a texture change — often rough or scaly — caused by abnormal skin cell growth from UV damage.

Can an AK turn into skin cancer?

Some can progress into squamous cell carcinoma (SCC). That’s why persistent, thick, tender or changing AKs should be assessed and treated.

Why do AKs keep coming back?

Because AKs often reflect field damage — the surrounding sun-exposed skin has ongoing abnormal change. Treating the whole zone (field therapy) can reduce recurrence better than repeated spot treatments alone.

Can I treat AK with over-the-counter creams?

Moisturisers can soften scale, but they don’t reliably clear AK. Effective treatments are usually in-clinic procedures or prescription-based field therapies (covered in Actinic keratosis treatment).

Should I worry if I have lots of AKs?

It’s a sign you need a structured plan and ongoing surveillance. The goal is to reduce AK burden and detect any SCC early.