Actinic Keratosis

Also known as solar keratosis, actinic keratosis is a prevalent skin condition with over 3 million new cases each year in the United States. An actinic keratosis starts as a rough, slow-growing, scaly patch on the skin, often found on areas with the greatest exposure to the sun, such as the face, ears, scalp, arms, neck or back of the hands. They occur due to years of sun exposure.

A precancerous skin lesion, actinic keratosis grows slowly and can turn into a squamous cell carcinoma—a potentially life-threatening skin cancer if left untreated. Anyone can get actinic keratosis, but it is most common in people who:

Work outdoors
Are older than 40
Don’t use sunscreen
Live in a sunny place
Have light-colored eyes
Have naturally red or blonde hair
Have a weakened immune system
Tend to freckle or burn when exposed to sunlight
Have a history of a lot of sun exposure or sunburns

million

new cases of actinic keratosis in the U.S. each year.

Symptoms

Symptoms of Actinic Keratosis

Not all actinic keratoses look the same, but some indicators include:

A hard, wart-like surface

Itching, bleeding, burning or crusting

Color variations including pink, red or brown

Flat or slightly raised bump or patch on the top layer of skin

A rough, scaly or dry skin patch, usually less than an inch in diameter

Bumps or patches usually on sun-exposed areas of the head, neck, hands and forearms

Diagnosis

Actinic Keratosis Diagnosis

Diagnosis of actinic keratosis begins with an examination of your skin. Your doctor may ask you questions, such as when you first noticed it and if it has changed. Most often, an actinic keratosis is diagnosed based on a clinical exam. However, sometimes your doctor may order additional tests, such as a skin biopsy. Before the biopsy, the doctor will numb the area where they will take a small sample of your skin to analyze under a microscope. 

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Treatments

Actinic Keratosis Treatments

Actinic keratosis should be treated to ensure they do not develop into squamous cell carcinomas. One option for this is medicated creams or gels. These products can cause redness, a burning sensation or scaling. Other options are surgical and include:

Freezing (cryotherapy)

Freezing is the most common method used to remove an actinic keratosis. The doctor will freeze the area with liquid nitrogen, which destroys the precancerous cells and causes the spot to peel away eventually.

Scraping (curettage)

The doctor uses a curet, a device to scrape off the spot.

Electrosurgery

In this procedure, the doctor numbs the area before using a pencil-shaped instrument that uses an electric current to destroy the spot.

Laser Therapy

Growing in popularity, the doctor will use an ablative laser to destroy the actinic keratosis.

Photodynamic Therapy

In this method, the doctor applies a light-sensitive solution to the spot then exposes it to a special light that destroys the actinic keratosis.  

Specialists