In the U.S, actinic keratoses represent the second most frequent reason for patients to visit a dermatologist. It begins as small rough patches that are easier felt than seen, often described as similar to rubbing sandpaper. With time, the lesions enlarge, usually becoming red and scaly. An actinic keratosis may follow one of three paths; it may regress, it may persist unchanged, or it may progress to an invasive skin cancer called a squamous cell carcinoma. Treatment consists of two broad categories; surgical destruction and medical therapy. The appropriate treatment is chosen normally based on the number of lesions present and the efficacy of the treatment. Additional variables such as patient age, history of skin cancer, and tolerability of the treatment choice are taken into consideration. To avoid these lesions, common sense sun safety should be practiced such as using a broad spectrum sunscreen, SPF 50, limiting outdoor activity during the peak sun hours of 10:00 – 3:00, and wearing protective clothing.