If you spend a lot of time in the sun, you might have noticed rough, scaly patches on your skin that won’t go away. While they may seem harmless, these could be precancerous skin lesions called actinic keratoses. Left untreated, they can turn into skin cancer. Let’s break down what they are, why they happen, and what you can do about them.
Want a quick video about precancerous skin lesions and what causes them? Check out my video here:
What Are Precancerous Skin Lesions?
Precancerous skin lesions are abnormal patches of skin that have the potential to develop into skin cancer over time. The most common type? Actinic keratoses (AKs)—small, rough, scaly spots that show up in areas exposed to the sun, like the face, scalp, hands, and arms.
Actinic keratoses are caused by years of ultraviolet (UV) radiation exposure, and they’re a warning sign that your skin has been damaged. While not every AK will turn into cancer, some can progress into squamous cell carcinoma (SCC), a type of skin cancer that can spread if not treated.
What Are the Risk Factors for Developing Actinic Keratoses?
Anyone can develop precancerous skin lesions, but certain factors put you at higher risk:
- Sun exposure: The more time you spend in the sun, the higher the risk.
- Fair skin: People with lighter skin, freckles, blond or red hair, and blue or green eyes are more vulnerable.
- Age: Most cases appear in people over 40, but they can develop earlier with excessive sun exposure.
- Weakened immune system: Those with weakened immunity due to medical conditions or medications are more likely to develop AKs.
- History of sunburns or tanning beds: UV damage builds up over time, increasing your risk.
If you check off multiple risk factors, it’s a good idea to keep a close eye on your skin!
Symptoms of Precancerous Skin Lesions: How Do They Look and Feel?
Actinic keratoses aren’t always easy to spot. They can be:
- Rough, dry, scaly patches that feel like sandpaper
- Red, pink, or brownish spots that blend into your skin
- Flat or slightly raised bumps that may be crusty or scabby
- Itchy or burning sensations on the affected area
- Tenderness or pain when touched
They’re most common on sun-exposed areas like the face, scalp (especially in bald spots), ears, hands, and arms.
How Are Precancerous Skin Lesions Diagnosed?
If you notice any suspicious skin changes, a dermatologist can examine them with a magnifying tool called a dermatoscope. In some cases, they might do a skin biopsy, where a small sample is taken and analyzed under a microscope to rule out skin cancer.
The good news? Actinic keratoses are highly treatable if caught early!
Treatment Options for Precancerous Skin Lesions
If you have precancerous skin lesions, your dermatologist may recommend one or more treatments to remove them and reduce the risk of progression to skin cancer:
1. Topical Medications
Prescription creams like 5-fluorouracil (5-FU) or imiquimod work by stimulating your immune system to destroy abnormal cells.
✅ Best for: People with multiple AKs or widespread sun damage.
2. Cryotherapy (Freezing the Lesions)
Liquid nitrogen is applied to the lesion, freezing and destroying it. The lesion then scabs over and falls off.
Quick and effective but may leave temporary redness or discoloration.
✅ Best for: Small, isolated AKs.
3. Photodynamic Therapy (PDT)
A light-sensitive drug is applied to the skin, followed by exposure to a special blue or red light that destroys damaged cells.
Can be more effective for larger areas but may cause temporary redness and peeling.
✅ Best for: Moderate to severe cases or multiple lesions.
4. Curettage and Electrodessication
The lesion is scraped off with a curette (a sharp instrument), and heat or electricity is used to destroy any remaining cells.
This method is typically used for thicker or stubborn AKs.
✅ Best for: Thick, crusty AKs that haven’t responded to other treatments.
How to Prevent Precancerous Skin Lesions
The best way to prevent precancerous skin lesions is sun protection:
☀️ Wear sunscreen: Use a broad-spectrum SPF 30+ sunscreen daily, even on cloudy days.
👒 Cover up: Hats, sunglasses, and UPF clothing protect vulnerable areas.
⏳ Avoid peak sun hours: Try to stay out of the sun between 10 AM and 4 PM.
🚫 Skip tanning beds: UV radiation from tanning beds increases your risk of AKs and skin cancer.
For extra skin support, topical antioxidants like vitamin C serum may help protect against UV damage.
Frequently Asked Questions
1. Are actinic keratoses the same as skin cancer?
No, but they are considered precancerous, meaning they have the potential to turn into squamous cell carcinoma if untreated.
2. Can precancerous skin lesions go away on their own?
Sometimes, but they often return. It’s best to have them evaluated by a dermatologist.
3. How do I know if an AK has turned into cancer?
Watch for rapid growth, pain, bleeding, or a sore that won’t heal—these can be signs of squamous cell carcinoma.
4. What happens if I don’t treat an actinic keratosis?
There’s a risk it could progress to skin cancer. Early treatment is key!
Final Thoughts
If you notice rough, scaly patches on your skin, especially in sun-exposed areas, don’t ignore them! Precancerous skin lesions like actinic keratoses are common, but they can be treated before they turn into something more serious. The best defense? Sun protection, regular skin checks, and early treatment. Have concerns about your skin? See a dermatologist for a professional evaluation. Your skin will thank you!
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