Skin

Actinic Keratosis: Signs and Symptoms

What Is Actinic Keratosis?

Actinic keratosis are scaly patches on your skin that develop over time from sun exposure. Mostly found on the back of hands, forearms, scalp, neck, lips, and face, these patches enlarge slowly. Actinic keratosis is also known as solar keratosis, and usually appears in people over the age 40.

While it is not common, actinic keratosis patches can become cancerous. In order to reduce your risk of actinic keratosis, be sure to minimize your sun exposure and use protection when you are. The symptoms of actinic keratosis are:

  • Typically, rough, dry, scaly patches of skin that are smaller than 1 inch in diameter.
  • Flat or slightly raised patch or bump on the top layer of skin.
  • Sometimes can appear as a hard, wart-like surface.
  • Patches can be pink, red, or brown.
  • Itching or burning in the affected patches

You should seek out your doctor’s advice when you develop a new spot or when a previous spot changes (grows/bleeds), so that they can evaluate if it is cancerous or not.

Some people are more at risk for developing actinic keratoses than others. Characteristics that put a patient more at risk are:

  • Over the age of sixty
  • Have light-colored skin and blue eyes.
  • Tend to get sunburns easily.
  • Have had serious sunburns in the past.
  • Have been in the sun frequently over their lifetime.
  • Have human papillomavirus (HPV)

How Is It Diagnosed?

Actinic keratosis is typically diagnosed by you dermatologist. They will take a look at the patches and be able to identify the condition. On occasion, your doctor might take a skin biopsy. This is a small procedure where the dermatologist will remove a small bit of your skin and examine it under a microscope to get a better idea of what the skin abnormality is.

Treatment:

Usually, actinic keratosis patches disappear on their own but can redevelop after further sun exposure. Actinic keratoses should be removed to avoid any risk of skin cancer. If any of your lesions become inflamed, enlarged, bleed, become red, or harden these are all signs of the condition developing into skin cancer. The main treatment option for actinic keratosis is medication. The dermatology medications that are prescribed to treat actinic keratosis are topical gels and creams. Some of these products include:

  • Fluorouracil cream (Carac, Fluoroplex, Efudex)
  • Imiquimod cream (Aldara, Zyclara)
  • Ingenol mebutate gel (Picato)
  • Diclofenac gel (Voltaren, Solaraze)

Other treatments include:

  • Cryotherapy (freezing). Patches can be removed by freezing them. After freezing, blistering will occur and once the blister heals, new skin will form, and the lesion will be gone.
  • Curettage (scraping). This procedure involves your doctor using a device to scrape off the damaged cells.
  • Photodynamic therapy. This type of therapy is a two-part treatment. The first part of treatment occurs when your doctor applies a solution that makes the AK patches sensitive to light. After about an hour, your doctor will then apply a blue or red light to the patch. The light when paired with the solution destroys the patches. Most patients need two treatments about three weeks apart.
  • Chemical Peel: Medical chemical peels can be performed by your doctor. The peel will destroy the top layers of the skin and new, healthy skin will grow in its place.

Prevention:

In addition to medical treatment, there are steps that you can take to prevent your risk of developing AK.

  • When you are going into the sun, wear clothing that protects your skin. Hats and long sleeve shirts will do the trick.
  • Try not to go outside during hours when the sun is at its brightest.
  • Never use tanning beds
  • Always apply SPF of 30 or higher when going outside. Even if it is not sunny, UV rays can still penetrate your skin causing sun. Using sunscreen with at least SPF 30 will block both the harmful UVA and UVB rays.

Be sure to check your skin regularly to ensure there are no signs of actinic keratosis. Additionally, if you have bumps, birthmarks, moles, or freckles be sure to note if there are any physical changes to these. If you do have symptoms, reach out to your doctor to seek treatment immediately.

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