Spot-on information on actinic keratosis

Spot-on information on actinic keratosis

If you’ve spent a great deal of time soaking up the sun over the years, there’s a good chance you’ll develop and notice skin lesions called actinic or solar keratoses (plural of keratosis). These small, rough, scaly or just flaky spots, typically found on areas most exposed to the sun, are one of the most common skin growths dermatologists treat.  This skin growth is so common, especially if you are fair-skinned, freckly and burn easily, that it is one of the most frequent reasons why people see a dermatologist.

What is actinic keratosis?

Actinic keratosis (AK) is causes by years of exposure to ultraviolet (UV) rays from the sun or indoor tanning beds.  It is important to see a dermatologist as they are considered precancerous and if left untreated, they may turn into a type of skin cancer called squamous cell carcinoma.  Most people get more than one and when they do, it is then called actinic keratoses, or AKs.

Actinic keratosis is not to be confused with seborrheic keratosis, which is a usually harmless skin growth.  Seborrheic keratosis can vary in appearance; most are usually white to tan to dark brown and have a rough, wart-like surface that can make them appear “stuck” on the skin. 

What do AKs look like?

Most AKs share common qualities that dermatologists can easily see.  These include the following:

·      Dry, scaly and rough textured skin

·      Some are skin colored while others can appear as red bumps, thick red scaly patches or growths, or crusted growths varying in color from red to brown to yellowish black.

·      A single AK may range from the size of a pinhead to larger than a quarter

·      Some AKs grow rapidly upward to where they resemble the horn of an animal which is called a “cutaneous horn.”

·      They can often fade or appear less prominent for weeks or months and then return. 

AKs tend to appear on skin that receives the most sun which includes:

·      Forehead, neck, chest, ears

·      Scalp, especially a bald scalp

·      Arms or hands

·      Lower legs, especially in women

AKs can also form on or at the border of the lip.  An AK on the lip is known as “actinic cheilitis” and looks like a white or grayish scaly patch on a dry, often cracked lip.

Who is more prone to developing AKs?

Those most prone for developing AKs are fair-skinned people, with light-colored hair and eyes.  Generally most AKs appear in adults over the age of 40.  However, if anyone has used an indoor tanning bed or lives in a sunny climate, such as Florida or California, AKs may form at an earlier age.  Others who are at a high risk for formation of AKs are anyone with a weak immune system or has a condition that makes them sensitive to UV rays.

Diagnosing AKs

To diagnosis AKs, a dermatologist can simply look at a person’s skin or by feeling the skin.  Sometimes a biopsy may be needed which is usually done during an office visit.  Either the entire growth is removed or a part of it.  The removed skin is sent to a lab to be examined under a microscope.

Treatment of AKs

If AKs are detected and found early, they can be successfully treated.  There are several therapies a dermatologist may use in treating this skin condition:

·      Cryosurgery – This is the most common treatment for AKs.  It involves freezing skin cells with liquid nitrogen to kill them and to remove the AK.

·      Photodynamic Therapy – A light-sensitive solution is applied to the skin followed by exposure to a special light to destroy the AK.

·      Curettage – This is a procedure that removes AKs by cutting or scraping them off.  This can be combined with heat (electrosurgery) to destroy diseased skin cells.

·      Chemical peel – This is a chemical solution applied to the skin to penetrate the skin deeply to destroy an AK.

·      Laser skin resurfacing – This uses a laser to remove AKs. 

·      Immunotherapy – This uses imiquimod cream and ingenol mebutate gel that work with the body’s immune system to help destroy AKs.

How to prevent AKs

The most important thing one can do to prevent AKs, is to protect skin from the sun and other sources of UV light such as tanning beds.  Other ways to protect skin include the following:

·      Seek shade particularly when the sun’s rays are strongest between 10 a.m. and 2 p.m.  If your shadow is shorter than you are, seek shade.

·      Wear protective clothing such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses.

·      Apply sunscreen every day.  Sunscreen should have a sun protection factor (SPF) of 30 or higher and offer broad spectrum protection (both UVA and UVB) and be water resistant.  They should be generously applied at least 15 minutes before going outdoors to all skin exposed such as the face, ears, and hands.

·      Reapply sunscreen every 2 hours, after swimming or sweating, even on cloudy days.

·      Do not use tanning beds or other indoor tanning devices. 

·      Protect your lips with a lip balm with an SPF of 30 or higher.

·      Inspect your skin regularly.  Contact a dermatologist if a growth on the skin has any of the following traits:

·      Starts to itch or bleed

·      Becomes noticeably thicker

·      Changes in size, shape, or color

·      Remains after treatment