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An actinic keratosis is a rough, scaly patch that forms on the skin due to prolonged exposure to the sun. It commonly occurs on areas such as the face, lips, ears, forearms, scalp, neck, or back of the hands.
This condition, also known as solar keratosis, typically develops gradually and is more frequently seen in individuals above the age of 40. By minimizing sun exposure and safeguarding the skin against ultraviolet (UV) rays, the risk of developing actinic keratosis can be reduced.
It is important to note that actinic keratosis is classified as a precancerous condition. This means that if left untreated, it has the potential to progress into skin cancer known as squamous cell carcinoma.
Symptoms
Actinic keratoses can manifest in various ways, presenting with the following symptoms:
- The affected skin area appears rough, dry, or scaly, typically measuring less than 1 inch (2.5 centimeters) in diameter.
- A patch or bump, slightly raised or flat, is visible on the outermost layer of the skin.
- Color variations may occur, including pink, red, or brown patches.
- Itching, burning, bleeding, or crusting sensations may be experienced.
- New patches or bumps can emerge on sun-exposed areas such as the head, neck, hands, and forearms.
- Horn-like growths may develop, protruding from the skin surface.
- Pain or tenderness might be present in the affected area.
Distinguishing between noncancerous spots and cancerous ones can be challenging. Therefore, it is advisable to seek evaluation from a healthcare provider when encountering new skin changes, particularly if a scaly spot or patch persists, grows in size, or starts to bleed.
Causes
Actinic keratosis is a condition that develops as a result of repeated or intense exposure to UV rays emitted by the sun or tanning beds. The UV light has the potential to harm the outer layer of skin cells known as keratinocytes.
Risk factors
Certain factors can increase the likelihood of developing actinic keratoses. These include:
- Possessing red or blond hair and having blue or light-colored eyes.
- Having a history of extensive sun exposure or sunburn.
- Being prone to freckling or burning when exposed to sunlight.
- Being over the age of 40.
- Residing in a sun-drenched location.
- Work outdoors
- Having red or blond hair and blue or light-colored eyes, as well as blue or green eyes.
- Having a compromised immune system.
Treatment
Actinic keratosis can sometimes spontaneously resolve, but there is a possibility of recurrence upon further sun exposure. Determining which actinic keratoses will progress into skin cancer is challenging, which is why they are typically removed as a precautionary measure.
To remove actinic keratosis, your healthcare provider may employ various methods:
- Medicines: If you have multiple actinic keratoses, your provider might prescribe medicated creams or gels such as fluorouracil, imiquimod, or diclofenac. These topical treatments can cause temporary skin inflammation, scaling, or a burning sensation.
- Surgical and other procedures:
- Cryotherapy: Liquid nitrogen is used to freeze and remove actinic keratoses. The freezing process causes blistering or peeling, and as the skin heals, the damaged cells are shed, allowing new skin to grow. Cryotherapy is a common and quick treatment typically performed in a healthcare provider’s office. Potential side effects include blisters, scarring, changes in skin texture, infection, and alterations in skin color.
- Scraping (curettage) and electrosurgery: In this procedure, your healthcare provider uses a curet to scrape off the affected cells. Electrosurgery may follow, using an instrument to cut and destroy the remaining tissue with an electric current. Local anesthesia is administered for this procedure. Potential side effects include infection, scarring, and changes in skin color.
- Laser therapy: Laser treatment is becoming increasingly popular for actinic keratosis removal. An ablative laser device is used to eliminate the affected patches, promoting the growth of new skin. Side effects may include scarring and skin discoloration.
- Photodynamic therapy: If you have multiple actinic keratoses or they reoccur after treatment, your healthcare provider may suggest photodynamic therapy. This approach involves applying special creams to the affected area and then using light therapy to destroy precancerous skin cells. During the healing process, it is important to avoid sun exposure for a few days.
