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After Years in the Sun: Actinic Keratitis

When men reach the age of 40 they are taught to be on the lookout for prostate and colorectal problems, but that's also the age they need to take a hard look in the mirror at their skin. Actinic keratitis, which can develop from years of exposure to the sun, can also be a precursor to skin cancer.

Actinic keratitis manifests as rough scaly patches, most commonly found on your lips, face, ears, forearms, scalp, neck or the back of your hands. The areas are usually less than 1 inch in diameter. They my be colored red, pink or brown, and can be characterized by a hard, wart-like surface. These patches grow very slowly, usually only becoming visible after the age of 40.

Although everyone is susceptible to the disease, you are more at risk if you have a history of sunburn; are of northern European ancestry (have red or blond hair, and blue or light-colored eyes); or have had your immune system weakened by AIDS, leukemia, chemotherapy, or organ transplant medications.

The big fear with actinic keratitis is that it develops into skin cancer, so see your doctor if you have any suspicions. In most cases, she will be able to diagnose the condition simply by looking at it. Alternately, your doctor may take a small sample of your skin for lab analysis.

An actinic keratosis can disappear on its own, but it is likely that your doctor will want to treat it pro-actively. Various topical products may be prescribed, including diclofenac gel, imiquimod cream, fluorouracil cream, and ingenol mebutate gel.

Photodynamic therapy, which is sometimes used to fight cancer, is also a tool to treat actinic keratitis. In this procedure, a photosensitizing agent – a drug that produces a form of oxygen that kills neighboring cells when exposed to certain wavelengths of light – is applied to the actinic keratoses.

The keratoses may also be removed by freezing them off, a process known as cryotherapy. After liquid nitrogen is applied to the affected area, your skin there will blister and peel. Eventually, the lesions will slough off and be replaced by a new layer of skin. As high-tech and involved as this sounds, cryotherapy is a quick procedure that is usually performed in your doctor's office.

The closest your doctor might get to actual surgery when treating your actinic keratitis is a process called curettage, which is just a fancy name for “scraping it off.” It is likely the curettage will be followed by electrosurgery, during which a small pencil-like electrode is used to remove what remains of the keratoses, under a local anesthetic.

 

Sources: The Mayo Clinic