Actinic Keratosis affects all ages from teenagers to adults. The condition occurs when tiny glands beneath the skin surface become clogged with sebum, an oily substance whose normal collection and excretion keeps the skin healthy. If clogged, bacteria can grow in the glands, which in turn cause swelling and pimpling. This process can be mild to severe for some patients. This process may occur anywhere on the skin where there are hair follicles, which includes common places such as the face, neck and back. There are other Actinic Keratosis type conditions that are more severe and affect other parts of the body. Actinic Keratosis can be a chronic condition for some.
Facts About Actinic Keratosis
An actinic keratosis is a rough, scaly patch on your skin that develops from years of exposure to the sun. The condition is most commonly found on the face, lips, ears, back of your hands, forearms, scalp or neck. Also known as a solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. These patches take years to develop, usually first appearing in people over 40. A small percentage of actinic keratosis lesions can eventually become skin cancer. Studies suggest that 5 percent (1 out 20) of all actinic keratosis develop into a squamous cell carcinoma. Avoiding sun exposure and protecting your skin from ultraviolet (UV) rays reduces risk for actinic keratosis thereby reducing the risk of squamous cell carcinoma.
Presentation of Actinic Keratosis
Actinic keratoses are found primarily on areas exposed to the sun, such as your face, lips, ears, hands, forearms, scalp and neck.
The signs and symptoms include:
- Rough, dry or scaly patch of skin, usually less than 1 inch (2.5 centimeters) in diameter
- Flat to slightly raised patch or bump on the top layer of skin
- In some cases, a hard, wart-like surface
- Pink, red or brown (pigmented)
Treatment
Medications
Prescription products that can be applied to the skin:
- Fluorouracil cream (Carac, Fluoroplex, Efudex)
- Imiquimod cream (Aldara, Zyclara)
- Ingenol mebutate gel (Picato)
- Diclofenac gel (Voltaren, Solaraze)
- These creams may cause redness, scaling or a burning sensation for a few weeks.
Photodynamic therapy
In photodynamic therapy, your doctor applies a chemical solution to the affected skin that makes it sensitive to the blu-light. The area is exposed to artificial light to destroy the damaged skin cells. Side effects may include redness, swelling and a burning sensation during therapy.
Surgical and other procedures
Your doctor may recommend a procedure for removal. The most common methods include:
- Freezing (cryotherapy). Actinic keratoses can be removed by freezing them with liquid nitrogen. Your doctor applies the substance to the affected skin, which causes blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. Cryotherapy is the most common treatment. It takes only a few minutes and can be done in your doctor’s office. Side effects may include blisters, scarring, skin texture changes, infection and darkening of the skin at the site of treatment.
- Scraping (curettage). In this procedure, your surgeon uses a device called a curette to scrape off damaged cells. Scraping may be followed by electro-surgery, in which the doctor uses a pencil-shaped instrument to cut and destroy the affected tissue with an electric current. This procedure requires a local anesthetic. Side effects may include infection, scarring and changes in skin coloration at the site of treatment.
Actinic Keratosis Considerations
Risks – Reduce risk of developing actinic keratosis by avoiding sun exposure and tanning beds.
Diagnosis – Seek an evaluation of persistent skin lesions in sun exposed regions.
Treatment – Diagnosis and treatment is key to prevent the development of skin cancer, most likely a squamous cell carcinoma.
