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How do I know if I have got an actinic keratosis?You are middle-aged or elderly and have enjoyed being in the sun. Likely, you continue going into the sun or do a lot of sports outside, have worked outside or lived abroad. If so, you are at risk of skin cancer and pre-cancerous lesions, such as actinic keratosis.
Actinic keratosis can be variable in its appearance. Even your body can have different appearances.  At first, they are hard to see and then more easily felt, being like rough sandpaper, and then they can grow.  They can be quite wide from 1 cm or 2 cm in diameter. Some are healthy skin coloured, others are pink, or reddish, or brownish.  They can become a little bit raised, hard and warty, and even get a bit of a horny outgrowth. They occur in areas that are already sun damaged. Moreover, areas with freckles, wrinkles and blotchy light brown marks melasma.
To the dermatologist, an actinic keratosis is diagnosed quickly. But in cases of doubt, they will do a small biopsy. Especially if they think there may be cancer within the lesion or affecting the whole injury.  They will then decide whether to biopsy all the actinic keratosis or just part of it. According to each individual and their findings.  A biopsy is done under local anaesthetic as an outpatient. The specimen sent for microscopic examination in the laboratory.
Actinic keratosis can be cured. But if you have already had the sun damage, you will be at risk of further actinic keratoses in the future. Especially in surrounding sun damaged skin.

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