Actinic keratoses (AKs) are lesions on the surface layer of the skin (epidermis) caused by chronic exposure to sunlight, particularly ultraviolet light. They may appear as rough or scaly skin, bumps, mottled patterns and cutaneous horns, commonly on the face (including ears and lips), neck, arms and hands. Actinic lesions can signal the onset of skin cancer and should be treated immediately. Dr. Pogue also performs biopsy and surgery for skin cancers. Routine re-examinations every few months and limitation of exposure to direct sunlight are recommended.