Actinic Keratosis

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You notice a small crusty spot on your skin that appears a bit worrisome. Everyone knows that certain lesions are considered to be pre-cancerous and this roughened area has been there for a while. You go to see the dermatologist and he confirms that the area is actinic keratosis and suggests some ways to treat it. What exactly is actinic keratosis and how concerned should you be?

Actinic keratosis, also called solar keratosis, are growths caused by excess sun exposure. Doctors do consider them to be precancerous. The areas appear bump-like and range in size from being a small pinpoint to over an inch across. Actinic keratosis first starts out as a flat or scaly blemish and then over time develops a crusty or horn-like covering. Actinic keratosis also come in a variety of colors from pink to red or can be tan in color. They typically are slow growing and so more commonly appear in older adults over the age of 40.

According to the American Osteopathic College of Dermatology (AOCD), half of actinic keratosis lesions will go away on their own if the areas are not exposed to the sun for a few years. However, the real concern is that 10 to 15 percent of the lesions that are more reddened and tender will progress to become squamous cell carcinoma and people with actinic keratosis are more likely to develop melanoma—the most serious form of skin cancer. Realistically, these spots are going to receive more sun exposure with time not less.

Squamous cell carcinoma may not be as life threatening as melanoma if treated early but still, around three percent of people will develop cancer spreading to other areas of their body. One of the most serious forms of actinic keratosis is called actinic cheilitis, which are whitish patches that develop on dry cracked or swollen lips. Those lesions have been found to develop into squamous cell cancer up to 20 percent of the time according to the AOCD.

Treatments:

A doctor will help you decide which of the treatments below are most practical for the type of actinic keratosis you have. They all have side effects such as potential for scarring, skin discoloration and increased sensitivity so make sure you understand the pros and cons of each.

• Freezing: a doctor uses liquid nitrogen to “freeze” off the lesion so new healthy skin will appear underneath.

• Scraping: a surgeon uses a special tool to scrape away the damaged cells and may follow the procedure using electric current to assure all the cells are destroyed. Local anesthetic will be used.

• Creams: certain chemotherapy creams can be applied to prevent cells from replicating or to stimulate one’s immune system to fight off the precancerous cells.

• Photodynamic therapy: A special sensitizing drug is used to make the cells sensitive to light followed with an intense laser light that destroys the actinic keratosis cells.

• Laser: special lasers can be used to remove actinic keratosis skin lesions

• Dermabrasion: A special high-speed brush buffs the actinic keratosis cells away. Local anesthetic is typically used.

Prevention:

People who have actinic keratosis are susceptible to developing even more lesions. Regular use of sunscreen and avoidance of over exposure to the sun are the first steps that will help prevent growth of these precancerous skin spots. Make a point of examining your skin regularly to detect any skin changes early, then follow up with your doctor.

Sources:

Actinic Keratosis
www.aocd.org/skin/dermatologic_diseases/actinic_keratosis.html
www.mayoclinic.com/health/actinic-keratosis/DS00568
Actinic Keratosis and Other Precancers
www.skincancer.org/actinic-keratosis-and-other-precancers.html
Solar cheilitis
http://dermnetnz.org/site-age-specific/solar-cheilitis.html

Edited by Alison Stanton

Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.