OBJECTIVES: Actinic keratosis is a highly prevalent epidermal neoplastic condition among people in the United States with fair skin and a history of long term UV exposure. A new self-assessment survey-based tool was developed to help people assess their risk of either having or developing actinic keratosis. The objective of this research was to assess detailed psychometrics of the developed survey. METHODS: A test questionnaire, comprised of 10 items, was initially developed using data obtained from subjects in routine clinical practice and interviews with dermatologists. The instrument was administered along with established and validated skin health assessment instruments (DLQI and Skindex-16) to 150 subjects prior to them being given a diagnosis of actinic keratosis by the dermatologist. A total of 75 subjects with a clinical diagnosis of actinic keratosis and 75 age/sex matched controls without actinic keratosis formed the sample for this study. Exploratory factor analyses, item response theory analyses, and other psychometric techniques were used to assess the reliability and validity of the Actinic Keratosis Risk Questionnaire (AKRQ). RESULTS: The final AKRQ instrument assessed was refined based on the results of exploratory factor analysis and item response techniques, ultimately limiting the scale to six items.  The resulting instrument had good internal consistency (Chronbachs alpha = 0.70) and correlations with other validated measures of skin quality of life (rho=0.596 with the Skindex-16 and rho = 0.429 with the DLQI, P<0.01).  The sensitivity, specificity, positive and negative predictive values of the AKRQ was found to be 69.3%, 73.3%, 72.2% and 70.5% respectively. CONCLUSIONS: The AKRQ is a reliable and valid tool which may help patients self-assess their risk of either having or developing actinic keratosis based on their skin health-related behavior and quality of life symptomatology.