Actinic keratosis

Description

Actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on the skin that develops from years of exposure to the sun. It is often found on the face, the lips, the ears, forearms, scalp, neck, or back of the hands.

Also known as solar keratosis, actinic keratosis grows slowly and usually first appears in people over 40. You can reduce your risk of this skin condition by reducing your exposure to the sun and protect your skin from ultraviolet rays (UV).

Left without treatment, the risk of actinic keratosis becoming a type of skin cancer called squamous cell carcinoma is approximately 5% to 10%.

Symptoms

Actinic keratosis may vary in appearance. The symptoms include:

  • Rough, dry, or scaly patch of skin, usually less than 1 inch (2.5 centimeters) in diameter
  • Flat to slightly raised patch or bump on the top layer of the skin
  • In some cases, a rough, warty surface
  • The variations of Color, including pink, red, or brown
  • Itching, burning, bleeding, or crusting
  • New patches or bumps on the skin in sun-exposed areas of the head, the neck, hands and forearms

When to see a doctor

It can be difficult to distinguish between cancerous spots, and cancer. So it's best to have new changes in the skin evaluated by a health care professional — especially if a scaly spot or patch persists, grows or bleeds.

Causes

Actinic keratosis is caused by frequent or intense exposure to ultraviolet (UV) rays from the sun or tanning beds.

Risk factors

Any person can develop actinic keratoses. But you're at higher risk if:

  • You have red or blond hair and blue or light-colored eyes
  • Have a story of a great amount of sun exposure or sunburn
  • Tend to freckle or burn when exposed to sunlight
  • Are more than 40 years
  • Live in a sunny place
  • Work in the open air
  • Have a weakened immune system

Complications

If treated in time, actinic keratosis can be deleted or removed. If left untreated, some of these places may progress to squamous cell carcinoma. This is a type of cancer that is generally not life threatening if detected and treated on time.

Prevention

Safety in the sun helps to prevent actinic keratosis. Take these steps to protect your skin from the sun:

  • Limit time in the sun. Above all, avoid the sun between 10 am and 2 pm, And avoid being in the sun so long that getting a sunburn or a tan.
  • The use of sunscreen.Before you spend time outdoors, apply a broad-spectrum water-resistant sunscreen with a sun protection factor (SPF) of at least 30, as the American Academy of Dermatology recommends. Do this even on cloudy days. The use of sunscreen on all exposed skin. And the use of a lip balm with sunscreen on the lips. Apply sunscreen at least 15 minutes before going outside and reapply every two hours or more often if you're swimming or perspiring. The sunscreen is not recommended for babies under 6 months of age. Rather, keep them out of the sun if possible. Or protect them with shadow, hats, and clothing that covers the arms and legs.
  • The cover-up. For additional protection against the sun, wear tightly woven clothing that covers the arms and legs. In addition, wear a wide-brimmed hat. This provides more protection than a baseball cap or visor golf.
  • Avoid tanning beds. The exposure to the UV rays from a tanning bed can cause so much damage to the skin as a tanning by the sun.
  • Check your skin regularly and report changes to your health care provider. Examine your skin regularly, looking for the development of new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp. Examine the top and bottom of the arms and hands.

The use of sunscreen. Before you spend time outdoors, apply a broad-spectrum water-resistant sunscreen with a sun protection factor (SPF) of at least 30, as the American Academy of Dermatology recommends. Do this even on cloudy days.

The use of sunscreen on all exposed skin. And the use of a lip balm with sunscreen on the lips. Apply sunscreen at least 15 minutes before going outside and reapply every two hours or more often if you're swimming or perspiring.

The sunscreen is not recommended for babies under 6 months of age. Rather, keep them out of the sun if possible. Or protect them with shadow, hats, and clothing that covers the arms and legs.

Actinic keratosis

Diagnosis

Your health care provider probably will be able to determine if you have an actinic keratosis simply by looking at your skin. If there is any doubt, your health care provider may do other tests, such as a skin biopsy. During a skin biopsy, a small sample of skin is taken for analysis in a laboratory. A biopsy may be done in a clinic after a numbing injection.

Even after treatment for actinic keratosis, your doctor may suggest that your skin checked at least once a year to detect signs of skin cancer.

Treatment

Actinic keratosis sometimes it goes away on its own, but could return after more exposure to the sun. It is difficult to say which of the actinic keratosis is going to develop skin cancer, so it is usually removed as a precautionary measure.

Medications

If you have a number of actinic keratoses, your health care provider may prescribe a medicated cream or gel to remove them, such as fluorouracil (Carac, Efudex others), imiquimod (Aldara, Zyclara) or diclofenac. These products can cause inflammation of the skin, flaking, or a burning sensation for a couple of weeks.

Surgical and other procedures

Many methods are used to remove actinic keratoses, including:

  • Freezing (cryotherapy). Actinic keratoses can be removed by freezing with liquid nitrogen. Your health care provider applies the substance to the affected skin, which causes the formation of blisters or peeling. As your skin heals, the damaged cells slough off, allowing new skin to appear. Cryotherapy is the most common treatment. It only takes a couple of minutes and can be done in the doctor's office. Side effects may include blistering, scarring, changes in the texture of the skin, infection, and changes in the color of the skin of the affected area.
  • Scraping (curettage). In this procedure, the doctor uses an instrument called a curet to scrape the damaged cells. Scraping can be followed by electrosurgery, in which a pencil-shaped instrument is used to cut and destroy the affected tissue with an electric current. This procedure requires local anesthesia. Side effects may include infection, scarring and changes in skin color of the affected area.
  • The laser therapy. This technique is increasingly used to treat actinic keratosis. Your health care provider uses an ablative laser device to destroy the patch, allowing new skin to appear. Side effects may include scars, and discoloration of the affected skin.
  • Photodynamic therapy. Your health care provider might apply a light-sensitive chemical solution on the affected skin and then exposed to a special light that will destroy the actinic keratosis. Side effects may include inflammation of the skin, swelling and a burning sensation during therapy.

Preparing for your appointment

It is likely to start by seeing your primary care provider. In some cases, when you call to schedule an appointment, you may be referred directly to a specialist in skin diseases (dermatologist).

What you can do

Your time with your doctor is limited, so preparing a list of questions will help you get the most out of your appointment. For actinic keratosis, some basic questions to ask include:

  • The tests are necessary to confirm the diagnosis?
  • What are my treatment options and the pros and cons of each one?
  • What will be the cost of the treatments? Does insurance cover these costs?
  • What suspicious changes in my skin should I look for?
  • What type of follow-up should I expect?

What to expect from your doctor

Questions your doctor may ask you include:

  • When did you first notice the patches or spots?
  • Have you noticed more of a patch or stain?
  • Have you noticed more changes in the affected skin?
  • Is the condition bothering?
  • She has had many sunburns or a very bad sunburn?
  • How often are you exposed to the sun or to ultraviolet (UV) radiation?
  • Protects your skin from UV rays when you are outdoors?
Symptoms and treatment of Actinic keratosis