Actinic Keratosis

Actinic keratosis (AK) are common precancerous growths that occur when the skin has been damaged by ultraviolet rays from chronic sun exposure or indoor tanning. If left untreated, actinic keratosis may progress into squamous cell carcinoma, a type of skin cancer. The good news is that AKs can be treated before they become skin cancers.

AK most commonly occurs on sun-exposed areas, including the face, ears, scalp, neck, foreheads, and backs of hands. They are pink-red in color and are often felt as rough dry spots on the skin. People who have fair skin, light hair and/or eyes are at greater risk of developing actinic keratosis.

Actinic keratosis is caused by excessive exposure to the sun or to indoor tanning. The ultraviolet rays damage the skin, causing unsightly lesions that can develop into cancer. Since it is caused by sun damage, is most common among fair-skinned people and among older people who have been in the sun more. A history of tanning, sunburns, and/or immunosuppression will also increase your risk of actinic keratosis.

Your dermatologist will likely be able to diagnose actinic keratosis by its characteristic appearance, but in some cases, a biopsy is needed to evaluate whether the actinic keratosis has progressed into a skin cancer. Precursor lesions which may progress into squamous cell carcinoma occur in up to 10% of cases and thus need to be treated.

Depending on the location, size and number of actinic keratosis you have, there are several different treatment modalities that may be used. Some of the common treatments for actinic keratosis include cryotherapy (freezing individual lesions) with liquid nitrogen) or field treatment for more diffuse/widespread involvement with topical chemotherapeutic agents, topical immunomodulators or photodynamic therapy.

There are also topical treatments such as chemotherapy cream that prevents cancerous cells from multiplying. Immune modulators such as imiquimod can also be used topically to prevent the growth of cancerous cells. Chemical peels are another topical treatment that uses a powerful acid to remove skin cells. While they are primarily used for rejuvenation, but strong peels can remove the entire upper layer of the skin, instantly removing the lesion. Side effects from peels can be temporarily painful or unsightly, so be sure to ask during your consultation if this is an appropriate treatment for you.