Feature Article

A GP’s guide to actinic keratosis

Gloria Fong, Patricia Lowe



Australia has the highest prevalence of actinic keratoses in the world. Due to the risk of transformation into invasive squamous cell carcinomas, actinic keratoses are routinely treated with an array of methods to prevent progression to invasive disease.

Key Points

  • Actinic keratoses (AKs) are premalignant lesions that have the potential to transform into in situ or invasive squamous cell carcinoma (SCC).
  • The main cause of AKs is chronic ultraviolet radiation- induced skin damage.
  • The diagnosis of AKs is a clinical one, although dermoscopy is a useful adjunct to diagnosis.
  • The use of high sun protection factor sunscreen and sun protection measures is the most important preventive measure for AKs.
  • Other treatment modalities for AK can be broadly divided into lesion-directed and field-directed.
  • Dermatologist referral is recommended for patients with lesions suspicious of SCC, extensive photodamage or immunosuppression and those at increased risk of developing SCC due to pre-existing medical conditions.

    Picture credit: © Hans-Ulrich Osterwalder/SPL