Actinic Keratosis vs Psoriasis

How to tell the difference — key features compared side by side.

Feature
Actinic Keratosis
Psoriasis
Category
Pre-cancerous
Common
Key feature
Rough, sandpaper-like patches from years of sun damage. The most common precancer - 5-10% progress to squamous cell carcinoma.
Chronic autoimmune condition causing thick, silvery scaly patches. Affects 2-3% of the population. Not contagious.
Risk factors
Cumulative lifetime sun exposure; Fair skin, light hair, light eyes (Fitzpatrick I-III); Age over 40
Family history of psoriasis (strongest risk factor); Stress (major trigger for flares); Obesity
Action needed
Any rough scaly patch on sun-exposed skin persisting more than two weeks
Persistent thick, scaly patches that do not respond to moisturizers

Actinic Keratosis

Actinic keratosis (AK) is the most common precancerous skin lesion, affecting an estimated 58 million Americans. It develops from cumulative ultraviolet radiation damage and represents the earliest stage toward squamous cell carcinoma.

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Psoriasis

Psoriasis is a chronic autoimmune condition in which the immune system mistakenly accelerates skin cell growth. Normal skin cells mature and shed in about a month; in psoriasis, this process takes only 3-4 days, causing cells to pile up into thick, silvery-white scales on red, inflamed patches.

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Does yours look more like actinic keratosis?

Quick self-check

Does this look like actinic keratosis? Answer 2 questions.

Does the spot feel rough or sandpaper-like?

Is it on a chronically sun-exposed area?

Still not sure?

Our full ABCDE checker evaluates 5 clinical criteria dermatologists use.

Full ABCDE check →