AKs develop slowly in the top layer of skin. They mostly start on
skin that’s often exposed to and damaged by the sun. This includes the face, ears,
bald scalp, neck, backs of hands and forearms, and lips. AKs tend to be flat spots
on the skin of the head and neck. But they appear as bumps on the arms and
The base of an AK may be light or dark, tan, pink, red, or a
combination of these. Or it may be the same color as the skin and a change you feel
rather than see. The scale or crust may be horny, dry, and rough. In some cases, the
spot may itch or have a prickly or sore feeling.
Sometimes the spots come and go, often coming back after sun
exposure. Often you will have more than 1 AK.
AKs that develop on the lip are called actinic cheilitis. They can
cause the lips to crack and feel scaly, dry, and rough.