Actinic keratosis (AKs) are common skin lesions caused by years of sun exposure. The fairer your skin the more likely these are to occur. AKs or solar keratoses tend to appear on skin that receives the most sun exposure, the forehead, ears, neck, arms, hands, scalps and lower legs. No matter where they occur, they are considered the earliest stage in the development of skin cancer.
What Causes Actinic Keratoses
AKs develop when the sun’s UV rays damage the skin cells called keratinocytes. These make up the outermost layer of the skin and give it it’s texture. Sun exposure can cause changes to these cell and make the skin rough, discolored and scaly. Bumps and horn-like growths can form. These can then progress to skin cancer.
What do AKs Look Like
The typical lesion is a dry scaly rough patch that is skin colored to reddish-brown. These may be very tiny or range to quarter sized or larger. They often feel like sand paper. Sometimes these grow rapidly and form a larger bump or protrude out in a horn-like growth. The sun damage can also affect the lips with dryness and cracking and scaling. Some lesions may come and some may seem to disappear and return again after a few months.
Treating Actinic Keratoses
CRYOSURGERY: This is the most common treatment for AKs. This involves applying liquid nitrogen to the actinic keratosis with a spray or an applicator. This freezes the skin cause the area to peel off. The area turns red and may blister. The area peels off and new skin forms.
TOPICAL CHEMOTHERAPY: This destroys SKs with a cancer-fighting cream or lotion (e.g. 5 fluoruracil) to kill the precancerous cells. The area will develop redness and may develop scabs which then slough, allowing healing to commence.
TOPICAL IMMUNOTHERAPY: This medication (e.g. imiquimod) stimulates the patient’s own immune system to destroy the AKS. This is applied by the patient at home. The area of skin treated may turn red and may develop scabs before healing.
TOPICAL NSAID THERAPY: patients apply this medication (sodium diclofenac gel) to the lesions at home. It will cause the lesion to develop red scabby areas at the sites of the AKs and sun should be avoided during treatment.
CHEMICAL PEELS: A chemical acid solution is applied to the skin in order to peel away the AKs and sun damaged skin. As the skin peels off, new healthier skin replaces it. The skin may be red with some crusts after the peel.
Actinic Keratoses Prevention
SEEK SHADE: If possible, seek shade, remember that the sun’s rays are strongest 10 a.m. to 4 p.m.
WEAR PROTECTIVE CLOTHING: Long sleeved shirts, pants, wide-brimmed hat and sunglasses provide increased safety. Many companies make light weight clothing made with UPF factor that helps shield the sun’s rays from harming the skin even when damp or wet.
WEAR SUNSCREEN: Generously apply sunscreen daily with an SPF of 30 or higher. Broad spectrum sunblocks protect against both UVB and UVA rays and all sunscreens should be applied initially 20 minutes before sun exposure. Reapply every 2 hours and use a generous amount to be safe in the sun.