What Is Actinic Keratosis?
As you get older, you may begin to notice rough, scaly spots
appearing on your hands, arms, or face. These spots are called actinic keratoses,
but they’re commonly known as sunspots or age spots. Actinic keratoses usually
develop in areas that have been damaged by years of sun exposure. They form
when you have actinic keratosis (AK), which is a very common skin condition.
AK occurs when skin cells called keratinocytes start to grow
abnormally, forming scaly, discolored spots. The skin patches can be any of
They tend to appear on the parts of the body that get the most
sun exposure. This includes the:
In most cases, actinic keratoses are not cancerous. They are
considered “in situ” stage
squamous cell carcinoma (SCC) lesions. “In situ” means the lesions are confined
to one location and not invading other tissues. When they’re left untreated,
however, up to 10
percent of actinic keratoses can progress into SCC. SCC is the second most
common type of skin cancer. Due to this risk, the spots should be regularly monitored
by your doctor or dermatologist.
What Causes Actinic Keratosis?
AK is primarily caused by long-term exposure to sunlight. You
have a higher risk of developing this condition if you:
- are over age 60
- have light-colored skin and blue eyes
- have a tendency to sunburn easily
- have a history of sunburns earlier in life
- have been frequently exposed to the sun over your
- have the human
papilloma virus (HPV)
What Are the Symptoms of Actinic Keratosis?
Actinic keratoses start out as thick, scaly, crusty skin patches.
These patches are usually about the size of a small pencil eraser. There might
be itching or burning in the affected area.
Over time, the lesions can disappear, enlarge, remain the same, or
develop into SCC. There’s no way of knowing which lesions may become cancerous.
However, you should have your spots examined by a doctor promptly if you notice
any of the following changes:
- hardening of the lesion
- rapid enlargement
Don’t panic if there are cancerous changes. SCC is relatively
easy to diagnose and treat in its early stages.
How Is Actinic Keratosis Diagnosed?
Your doctor may be able to diagnose AK simply by looking at it. They
may want to take a skin biopsy of any lesions that look suspicious. A skin
biopsy is the only foolproof way to tell if lesions have changed into SCC.
How Is Actinic Keratosis Treated?
AK may be treated in the following ways:
Excision involves cutting the lesion from the skin. Your doctor
may choose to remove extra tissue around or under the lesion if there are
concerns about skin cancer. Depending on the size of the incision, stitches may
or may not be needed.
In cauterization, the
lesion is burned with an electric current. This kills the affected skin cells.
Cryotherapy is a type of
treatment in which the lesion is sprayed with a cryosurgery solution,
such as liquid nitrogen. This freezes the cells upon contact and kills them.
The lesion will scab over and fall off within a few days after the procedure.
Certain topical treatments called chemical peels, such as 5-fluorouracil, kill the affected skin
cells and cause the lesion to scab over and drop off. While this type of
treatment can get rid of the lesions, it may be temporarily disfiguring. Make
sure to ask your doctor about the possible side effects of chemical peels and
what to expect after treatment.
a solution is applied over the lesion and the affected skin. The area is
then exposed to intense laser light that targets and kills the cells. Common
solutions used in phototherapy include prescription medications, such as aminolevulinic
acid and methyl aminolevulinate cream.
Immunotherapy can involve
the use of Imiquimod, which is a topical cream that can be applied to the
lesion several times a week. The cream increases the activity of the body’s
immune system, but it’s not exactly known why this helps treat AK.
How Can Actinic Keratosis Be Prevented?
The best way to prevent AK is to reduce your exposure to
sunlight. This will also help minimize your risk of skin cancer. Remember to do
- Wear hats and shirts with long sleeves when
you’re in bright sunlight.
- Avoid going outside at midday, when the sun is
- Avoid tanning beds.
- Always use sunscreen when you’re outside. It’s
best to use a sunscreen with a sun protection factor (SPF) rating of at least 30.
It should block both ultraviolet A (UVA) and ultraviolet B (UVB) light.
It’s also a good idea to examine your skin regularly. Look for
the development of new skin growths or any changes in all existing:
Make sure to check for new skin growths or changes in these
- the tops and undersides of your arms and hands
Schedule an appointment with your doctor as soon as possible if
you have any worrisome spots on your skin.