What condition can be mistaken for actinic keratosis?

Actinic keratosis can look like other skin conditions, such as seborrheic keratosis. Some types of skin cancer, like basal cell carcinomas, can also look like actinic keratosis.

How can you tell the difference between actinic keratosis and seborrheic keratosis?

Actinic keratosis and seborrheic keratosis can look similar but have some key differences. Seborrheic keratosis lesions can be flat plaques like actinic keratosis lesions, but they tend to be a little more raised. They look kind of like a sticker someone stuck on their skin. A seborrheic keratosis lesion usually feels rough but can be waxy. Actinic keratosis tends to feel dry and crusty.

Pictures of Actinic Keratosis, Moles, Nevus, and Psoriasis

Some spots on your skin like actinic keratosis or nevi aren't a problem at first. However, these skin spots might increase your risk of skin cancer later on, or even turn into cancer.

While looking at pictures of actinic keratosis or psoriasis might help you figure out what skin condition you're dealing with, it doesn't replace an expert's exam.

Of course, diagnosing skin cancer is far from straightforward, so if you have any doubts, contact your dermatologist or primary care provider.

These pictures of actinic keratosis and other skin conditions can help you see the differences between cancerous, noncancerous, and precancerous lesions.

Actinic Keratosis on an Arm

Actinic Keratosis skin cancer — Jodi Jacobson / Getty Images

Actinic keratosis, also called solar keratosis, is usually caused by too much sun exposure. It can also be caused by other factors such as radiation or arsenic exposure.

They appear predominantly on sun-exposed areas of the skin such as the face, neck, back of the hands and forearms, upper chest, and upper back. You can also develop keratoses along the rim of your ear.

In pictures of actinic keratosis, you'll see they are typically pink, scaly, and flat. It's also common to have harmless brown spots or "liver spots."

Actinic keratosis is caused by cumulative skin damage from repeated exposure to ultraviolet light, including that found in sunshine. Sometimes actinic keratoses can develop into an invasive and potentially disfiguring skin cancer called squamous cell carcinoma.

Most actinic keratoses are not premalignant. Only about 10% will become squamous cell carcinomas.

Pictures of Actinic Keratosis on a Scalp

Actinic keratoses are precancerous lesions common on sun-exposed areas of the skin. They can assume many different appearances, but this image shows a very common presentation of AKs on a balding head. — Future FamDoc/Wikimedia Commons/CC-BY-SA-4.0

Areas with high sun exposure such as the scalp (on bald individuals), forearms, face, and back of the neck are common sites for actinic keratoses.

If you're looking at pictures of actinic keratoses on the scalp and comparing it to what your skin looks like, you'll see flat, scaly lesions. Sometimes, the lesions get crusty. They may turn pink or red, or just be the same color as your skin.

Pictures of Actinic Keratosis on an Ear

In pictures of actinic keratoses on the ear, you'll see the lesions on the top. This is an area of skin that tends to get a lot of sun exposure. The brown spots in the photo are scaly and rough. They can also bleed.

Pictures of Actinic Keratosis Close-Up

Actinic keratoses lesions feel rough and dry, which often makes them easier to feel than to see—especially up close.

When you look at pictures of actinic keratoses close up, you might notice some different details about them.

For example, the lesions are initially flat and scaly on the surface and become slightly raised. Over time, they become hard and wart-like or gritty, rough, and sandpapery.

Actinic keratoses may develop a horn-like texture (called a cutaneous horn) from an overgrowth of the skin keratin layer also known as hyperkeratosis.

Pictures of Spitz Nevus

SKIN: VARIANTS OF BENIGN ACQUIRED NEVI SPINDLE AND EPITHELIOID CELL NEVUS (SPITZ NEVUS) The lesion is small, symmetrical, and uniformly pink-tan in color. — The Armed Forces Institute of Pathology/Wikimedia Commons

Children may develop a benign lesion called a Spitz nevus. If you look at pictures of a Spitz nevus, you'll see the mole is typically firm, raised, and pink or reddish-brown.

It can also be smooth or scaly and usually appears on the face, particularly the cheeks.

A Spitz nevus is not harmful but may be difficult to differentiate from melanoma, even for experts.

The Noncancerous Spitz Nevus Mole

Pictures of Atypical Nevi

Congenital melanocytic nevus. Brown papule on the nose, which developed shortly after birth. The brownish exophytic lesion is well circumscribed. — M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara/Wikimedia Commons/ CC-BY-2.0

Although most moles are benign, certain types of moles carry a higher risk for melanoma. It's possible that up to 50% of the population has moles called dysplastic nevi, which are larger than ordinary moles.

If you look at pictures of atypical nevi, you'll see that most are 5 mm across or larger, have irregular borders, and come in various shades or colors.

If you have dysplastic nevi plus a family history of melanoma—a syndrome known as FAMM—you have a high risk for developing melanoma at an early age, younger than 40.

Similarly, giant congenital nevi (shown in the photo above), are major risk factors for melanoma. In such cases, cancer usually appears by age 10.

Pictures of Psoriasis

Psoriasis is an autoimmune skin condition that can increase your risk of developing squamous cell carcinoma. Studies conflict on whether it has any effect on melanoma. There is some evidence that long-term treatment for psoriasis using UVA radiation (PUVA) may increase your risk of melanoma.

If you look at pictures of psoriasis, you'll see that it looks like red, scaly patches of skin. These patches are often very itchy and dry.

Pictures of Keratoacanthoma

Keratoacanthoma of the breast — Jmarchn/Wikimedia Commons

Keratoacanthomas are a low-grade subtype of squamous cell carcinoma. The majority occur in sun-exposed skin, usually on the hands or face.

They are typically skin-colored or slightly red when they first develop and can grow rapidly to 1 to 2 cm in size. Most will spontaneously get better within 1 year, but they almost always scar after healing.

Removal by surgery, or sometimes by radiation, is recommended. In cases not appropriate for excision, due to their size or location, keratoacanthomas may be treated with 5-fluorouracil, a type of medication used to treat cancer, either as a cream or by injection.

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Summary

Most skin blemishes aren't harmful. That said, if you notice any spots on your skin, it's important to keep an eye on them. You should also know the signs of skin cancer and make an appointment with your provider if you're concerned about any areas on your skin.

Frequently Asked Questions

What condition can be mistaken for actinic keratosis?

Actinic keratosis can look like other skin conditions, such as seborrheic keratosis. Some types of skin cancer, like basal cell carcinomas, can also look like actinic keratosis.
How can you tell the difference between actinic keratosis and seborrheic keratosis?

Actinic keratosis and seborrheic keratosis can look similar but have some key differences. Seborrheic keratosis lesions can be flat plaques like actinic keratosis lesions, but they tend to be a little more raised. They look kind of like a sticker someone stuck on their skin.
A seborrheic keratosis lesion usually feels rough but can be waxy. Actinic keratosis tends to feel dry and crusty.

11 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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