Difference between Actinic Keratosis and Eczema

Sun and tanning bed exposure over a lifetime leads to actinic keratosis, also known as solar keratosis, the most prevalent premalignant skin disease.

Inflammatory eczema often appears in infancy or early childhood and has a hereditary component. Rash is the most prevalent sign, followed by dryness, redness, and itching. It most frequently manifests itself on the extremities, but can also show up on the face, hands, neck, or even the backs of the knees.

What is Actinic Keratosis?

Actinic keratosis develops when epidermal keratinocytes undergo alterations.

  • Causes and prevalence − Actinic keratosis is caused by being exposed to the sun's UV rays. The illness manifests up after repeated sunburns over time and often affects those with fair skin in their medium to late adult years.

  • Symptoms and complications − Areas of skin change texture and appearance, becoming rough and scaly. They often manifest as round, dry areas of skin with a diameter of less than 2.5 cm. Pink, red, or brown patches of skin are common in places that receive a lot of light, such the face and arms, and are caused by the sun's ultraviolet rays. It is a precancerous state that can progress to squamous cell carcinoma.

  • Diagnosis − This disorder can be diagnosed with certainty by a clinical examination of the skin and a biopsy of skin lesions.

  • Treatment − Ointments containing alpha-hydroxy acids or the chemical tretinoin can be applied to the affected areas of the skin. It is possible to use electrocautery to remove the skin samples for analysis. Future sun or tanning bed exposure should be avoided since this might cause the condition to persist or even worsen. The skin may be shielded from the sun by using sunblock and by wearing protective gear.

What is Eczema?

Dry, itchy patches of skin are the hallmark of eczema, an inflammatory skin disease. A rash appears on the backs of the knees, the upper arms, the hands, and the neck. Eventually, the rash will become red and dry.

Differences: Actinic Keratosis and Eczema

The following table highlights the major differences between Actinic Keratosis and Eczema −


Actinic Keratosis



Actinic keratosis is a kind of skin growth or patch that appears on sun-damaged skin and is often rough and scaly. This skin disease typically manifests itself on the extremities. The Sun can cause this condition, which is also known as solar keratosis. Actinic keratosis is often innocuous, although a small number of cases (about 10 percent) progress to cutaneous squamous cell carcinoma (a keratinocyte cancer).

Itchy, rashy skin is a symptom of eczema, a skin ailment. Although more frequent in kids, it can also affect grownups. It leads to persistent inflammation that flares up periodically.


  • Scaly, patched, thickened and rough skin. These skin patches (usually less than 1 inch (2.5 centimeters) in diameter) are often termed as plaques

  • Clusters of plaques in the same region

  • Growths may appear and vanish in the same area

  • A hard, bumpy wartlike surface in some cases

  • Tender or asymptomatic

  • Poorly marginated, slightly raised or flat lesions

  • Lesions usually vary inconsistently in shade tone like yellowish, brownish, skin colored or black to blotchy

  • Lesions bleed on touching. They even change in shape, texture and color. The sores developed due to this condition takes a longer duration of time to heal

  • It is common on sites that areexposed to the sun light repeatedly, nose, ears, upper lip, vermillion of the lower lip, forehead, temples, back of the hands, cheeks, and the balding scalp.

  • In rare cases, affected areas may show symptoms like burning sensation, itching, or cause other unpleasant or uncomfortable sensations.

  • Red, inflamed or swollen skin

  • Tiny fluid-filled blisters (vesicles)

  • Dry, easily irritated skin

  • Intense itching – more in people with eczema and possibility of infections to develop

  • Patches of dark skin

  • Leathery crusts or scabs that form when the fluid dries

  • Scaly patches of skin (lichenified skin)

  • Itchy red patches on the legs

  • Itchy forearms

  • Red raised bumps due to excess blood flowing through the blood vessels on the inner elbow

Risk Factors

  • Are above 60 years of age

  • Possess light skin tone and blue eyes

  • Possess a tendency to easily sunburn

  • Have been exposed to sunlight over lifetime

  • Are suffering from HPV (Human Papilloma Virus)

  • Possess a history of sunburns (genetics)

  • Hereditary factors (genetics) –

  • eczema runs in families

  • Immune system dysfunction resulting in an undesired inflammatory response in the skin

  • Irritants and allergens like pollen, certain foods, wool, excess heat, moulds, dust mites, soaps and detergents, skin infections, reduced humidity, sweating or mental stress.


  • Excision

  • Cauterization – the lesion or the affected area is burnt and cells killed using electric current

  • Cryotherapy – the lesion or the affected area of the skin is sprayed with a cryosurgery solution (liquid nitrogen). The cells get frozen and destructed. The lesion will scab over and get removed in some days after the cryotherapy.

  • Topical medical therapy – ingenol mebutate (Picato), 5- fluorouracil and imiquimod (Aldara, Zyclara) cause inflammation and destruction of the lesions.

  • Phototherapy – a medical solution is applied over the affected area of the skin. Then intense laser light is used over the lesion that kills the cells.

  • Avoiding irritants or certain factors (allergens) that could flare up the condition

  • Using emollients like bath oils and moisturisers.


Actinic Keratosis and Eczema are both conditions of the skin, however there are quite a few differences between them, which we discussed in this article.

Updated on: 01-Mar-2023


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