Actinic Keratosis Treatment

Providing the most advanced Actinic Keratosis Treatments

What is Actinic Keratosis?

Actinic keratoses (AKs) are considered the earliest stage in the development of skin cancer. They are common lesions of the epidermis (outermost layer of the skin), and are caused by long-term exposure to sunlight. AKs are most likely to appear after age 40, however, in geographic areas with year-round high-intensity sunlight such as Florida and southern California, AKs may be found in persons as young as the teens and twenties. Half of all older, fair-skinned persons who live in hot, sunny areas have AKs. The most significant predisposing factor to AKs is fair skin and long-term sun exposure.

Chronic sun exposure causes skin cells to change size, shape, and the way they are organized. The skin cells affected in AKs are the keratinocytes. Keratinocytes are the tough-walled cells that make up 90 percent of the epidermis and give the skin its texture.

Changes in keratinocytes can be seen when the skin becomes rough, scaly, or mottled, and develops bumps or small horn-like growths. Further changes in cell growth can turn AKs into squamous cell carcinoma, a type of skin cancer.

What do actinic keratoses look like?

Actinic keratoses are found on chronically sun-exposed skin, most commonly on a fair-skinned person, middle-aged or older. They are commonly found on the sides of the forehead, the ears, the scalp of bald men, and the backs of the hands. The typical AK lesion is a dry, scaly, and rough skin-colored to reddish-brown "bump" on the skin. AK lesions may range from the size of a pinhead to larger than a quarter. Skin-colored AK lesions may be noticed more by touch because they tend to have a sharp, hard scale and feel like sandpaper. They are often sensitive or "touchy." Wrinkling, furrowing, and other signs of sun damage may be present with AK lesions.

Sometimes the skin cells making up an AK lesion undergo abnormal growth and become a "cutaneous horn." The cutaneous horn gets its name from its appearance because it can look like the horn of an animal. The size of a horn may vary from a pinhead to a pencil eraser; and its shape may be straight or curved. The external ear is a common site for a cutaneous horn.

An actinic keratosis can also appear as a scaling lesion on the lower lip that dries and cracks open. An AK at any location may at times seem to disappear for weeks or months and then return at the same place. If they are picked off they grow back.

Treatment of Actinic Keratoses

• Cryosurgery - Liquid nitrogen "freezes" surface skin, which flakes off and is replaced by new skin. Skin redness is the chief side effect. Cryosurgery is the most commonly used treatment.
• Topical Chemotherapy - A topical anti-cancer cream or lotion (e.g., 5-fluorouracil) is applied to the skin to treat and bring out actinic keratoses lesions. A localized red spot may remain for a while at the site of a treated AK.
• Photodynamic Therapy - A natural chemical is applied to the skin; after a few hours, the skin is exposed to "blue" light that activates the chemical to destroy the actinic keratoses. Localized red areas develop in treated regions which fade after several days.
• Chemical Peeling - A chemical solution is applied to the skin. This causes the skin to peel off over a period of days. As the treated skin peels, new skin forms to replace it. Your dermatologist or dermatologic surgeon will select a chemical solution to accomplish a mild, medium, or deep peel. The principal side effect is redness and swelling of skin for a period of time after the treatment.
• Laser Skin Resurfacing - A series of treatments with the carbon dioxide laser removes surface skin to a desired depth. Post-treatment skin redness is the principal side effect. A week or two of healing is needed.
• Treatment should be fully and openly discussed with your dermatologist and/or dermatologic surgeon. After AKs are removed, the new skin must be protected from new solar damage by a program of skin care that includes sun protection.

Prevention of Actinic Keratoses

Prevention of AKs should begin early in life. Sun damage to unprotected skin begins in childhood and puts the child at risk for actinic keratoses and skin cancer later in life. However, it is never too late to initiate prevention of new actinic keratosis lesions in adulthood.

The basics of Actinic Keratosis prevention are:

• Avoid excessive exposure to sunlight during peak sunlight hours (10am to 4pm).
• Wear clothing that covers arms and legs, and wear a wide brimmed hat.
• Use a sunscreen with a sun protection factor (SPF) of 15 or higher daily. Apply at least 20 minutes prior to sun exposure for maximum sun protection.

• Select a broad-spectrum sunscreen that provides both UVA and UVB protection, and reapply sunscreen every 11/2 hours when outdoors, even on cloudy days.

 

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