Actinic keratoses (AKs)

Actinic keratoses (AKs) are common and may be characterized by rough, red, scaly patches, crusts or sores. They are often referred to as “precancers” of the skin. In approximately 10-15% of cases, they transform to a skin cancer called squamous cell carcinoma (SCC).

  • AKs are usually found on the face, lips, scalp, neck, forearms, and back of the hands – areas of chronic sun exposure.
  • Individuals with fair skin or poor immune systems are at greater risk for developing AKs.
  • AKs take years to develop, and while they are more commonly found on older individuals, even people in their 20s and 30s can develop AKs.

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Actinic Keratoses Diagnosis puget sound dermatology
Actinic Keratoses Diagnosis Puget Sound Dermatology

Treatment For Actinic Keratoses

The goal of treatment of AKs is to prevent the development of skin cancer. There are a number of therapies are available:

  • In office cryotherapy (liquid nitrogen spray).
  • Topical medications for home use including tretinoin, diclofenac, 5-fluorouracil, imiquimod,  and ingenol mebutate (Picato).
  • In office photodynamic therapy after application of aminolevulinic acid (ALA-PDT).  PSDerm does not offer this procedure, but we are happy to refer you to our local colleagues.

Meet Our Providers

Our providers continue to maintain the highest levels of accreditation and progressive ongoing education to learn and understand the latest developments in medical dermatology. Each provider's education and bio can be viewed below.


Melanie Kuechle, MD

Dr. Kuechle is a native of Texas and a graduate of Baylor University College of Medicine. She completed her dermatology residency at...


Dr. Jill McKenzie

Dr. Jill McKenzie graduated from Washington State University with her Bachelor of Science degree, Magnum Cum Laude.  She attended the University of...


Ame Phitwong

Ame is a board certified Adult-Gerontology Primary Care Nurse Practitioner who has worked entirely...


Dr. Craig Birkby

Dr. Craig Birkby has been a leader in the treatment of skin cancer in the Seattle area for over 20 years. He attended medical school at...