Actinic Keratosis

Overview of Actinic Keratosis

A skin condition caused by UV rays from the sun is called Actinic Keratosis (AK). It is a very common pre-cancer formed due to damaged skin by chronic exposure to UV rays and/or sometimes from indoor tanning.

Solar Keratosis is the second name for actinic keratosis. Long-term exposure to UV radiation can lead to the development of actinic keratosis (plural) in the future. This means that the risk of getting skin cancer is higher.

It is one of the most common skin conditions that affect people over age 40. 

Appearance of Actinic Keratosis

The appearance of AK varies depending on the stage of prognosis. It is mostly found on the sites on the skin, where sun exposure is longest such as the face, hands, and arms. On the face areas such as lips, nose, ears, and forehead are affected.

The most prominent features are:

  • Red or pigmented skin (light, dark tan, or a combination of colors)
  • Tender or asymptomatic
  • A flat or thickened papule or plaque
  • White or yellow; scaly, warty, or horny surface
  • Rough texture
  • Easier to feel than see

AK on the lower lip is known as actinic cheilitis. 

Signs and Symptoms of Actinic Keratosis

Signs and symptoms include: 

  • Itching and burning in the affected area
  • Hard, wart-like surface
  • Hard to touch
  • A rough, dry, scaly patch of skin
  • Coloured skin 
  • Flat to slightly raised patch or bump on the skin
  • Sometimes a cluster of patches
  • Horny growth on the skin

Types of Actinic Keratosis

Causes of Actinic Keratosis

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Risk Factors of Actinic Keratosis

If left untreated, actinic keratosis can, later on, develop into squamous cell carcinoma, a type of skin cancer. Individuals are at risk if they have:

  • History of unprotected exposure
  • Geographic location; live in a sunny area
  • Weakened immune system
  • Fair skin
  • Age over 40
  • Tend to freckle, when exposed to sunlight

Health Complications of Actinic Keratosis

With early treatment, actinic keratosis can be easily treated and removed from the skin before they develop into cancer.

  • If left untreated, it develops into squamous cell carcinoma
  • Cutaneous horn may arise
  • Basal cell carcinoma can also develop
  • Chances of melanoma
  • Merkel cell carcinoma may develop as well

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Prevention

The best possible preventive measures for actinic keratosis are as follows:

  • Avoid unguarded and prolonged exposures to sunlight
  • Make sure to apply sunscreen every day 
  • Do not visit tanning salons, sun lamps, or tanning beds frequently 
  • Remember to wear long-sleeve shirts and avoid wearing shorts 
  • Use sunscreen which blocks both UVB and UVA light
  • Wear a hat that covers your ears and not just your hair 
  • Choose a “broad spectrum” sunscreen
  • Reapply the sunscreen during humid weather conditions 
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Diagnosis

A diagnosis is given by the doctor by simply examining the skin. If there is a doubt, a skin biopsy might be performed.

Treatment of Actinic Keratosis | When to Consult a Doctor

AK can disappear on its own. A reappearance occurs after more sun exposure. Removal is suggested, to hinder the progress into a carcinoma.

Topical Treatment

If the actinic keratosis is widely spread and at an early stage, instead of removal, prescribed medication is used. Creams, gels, and solutions are applied directly to the affected area:

  • 5-Fluorouracil cream 
  • Imiquimod cream 
  • Ingenol mebutate gel 
  • Diclofenac gel and hyaluronic acid

*All medication is to be used as prescribed by the doctor

Surgical Procedures

Surgery is recommended when a person has one or more isolated lesions. 

  • Chemical Peel: A chemical peel is applied to the affected area, causing the top skin layers to peel off.
  • Cryosurgery: Liquid nitrogen is used to freeze the tissue, which falls off and healthy skin emerges.
  • Laser: Laser beam is used to vaporize the lesion.
  • Curettage and Desiccation: Lesion is shaved or scraped off, then heat or chemical agent is used to destroying remaining AK calls and stop bleeding.
  • Photodynamic Therapy: A light-sensitizing topical agent is applied for a period followed by exposure to blue or red light to kill cancer cells.

Combination Therapies

Different treatment regimens may be paired together, including

  • Cryosurgery and PDT
  • Cryosurgery and a topical treatment
  • Topical treatments and PDT

After treatment, it is essential to perform a self-check and be careful about safeguarding the skin from UV rays.

If you have even the slightest indication of having actinic keratosis, visit a dermatologist and get your skin checked.