What Do AKs Look Like?

Actinic keratoses (AKs) are found on areas of the body that have received long-term exposure to sunlight, such as the face, ears, lip, scalp, neck, forearms, and back of the hands.

While AKs share common characteristics, such as being dry, scaly, and rough textured, not all AKs look alike. Some are skin-colored and may be easier to feel than see. These lesions often feel much like sandpaper. Others can appear as red bumps; scattered, thick red scaly patches or lesions; or crusted lesions varying in color from red to brown to yellowish black.

When an AK undergoes rapid upward growth, it becomes a “cutaneous horn,” so named because it resembles the horn of an animal. The size of a cutaneous horn may range from that of a pinhead to a pencil eraser, and the shape may be straight or curved. Sometimes skin cancer hides below a cutaneous horn.

If an AK forms on the lip, it is called “actinic cheilitis” and appears as a diffuse, scaling lesion on the lower lip that dries and cracks.

The skin around an AK tends to show evidence of sun damage, such as wrinkles and furrows (deep wrinkles). The size of an AK ranges from a pinhead to larger than a quarter.

The photographs below show several diagnosed cases of AKs and illustrate the fact that AKs appear in various sizes, colors, and shapes.

Click on the thumbnail for an enlarged image.

AKs Common on the Hands

A fair-skinned elderly patient with numerous crusted papules on the backs
of both hands and other chronically
sun-exposed parts of the body.

This 45-year old fair-complexioned patient is a kidney-transplant recipient who has both AKs and squamous cell carcinoma, a type of skin cancer, on his hand.

AKs Frequently Appear on Face and Ears

One of the most frequent places AKs appear is the face as shown in this photograph.

This retired construction worker developed these slightly tender papules and crusts on his ears over an eight to 10-year period.

Actinic Cheilitis Occurs on the Lip

This elderly farmer gradually noticed a white discoloration on his lower lip that was accompanied by occasional crusting and tenderness.

Cutaneous Horn: A Type of AK

Sometimes the skin cells making up an AK lesion undergo rapid upward growth and form a cutaneous horn as shown on this patient’s forehead.

The cutaneous horn often appears on an ear as shown in this photo.

(Photos used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

Be sure to see a dermatologist if you notice a lesion that looks like any of the above or a lesion that begins to thicken, bleed, itch, or grow.

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AKs are a common, potentially serious skin condition that may be characterized by rough, scaly patches, crusts or sores, ranging in size from a pinhead to larger than a U.S. quarter.

American Academy of Dermatology





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