Also called solar keratosis, actinic keratosis is a precancerous skin growth caused by the sun or indoor tanningIf a patient finds a spot or growth on their skin that you think could be an actinic keratosis (AK), the American Academy of Dermatology Association (AAD) warned that it’s time for a thorough skin examination. 

Actinic keratosis tends to appear on skin that’s been the most badly damaged by the sun. That’s why they often appear on the face, ears, balding scalp, hands, neck, or lips.

SIGNS & SYMPTOMS 

Usually, the first signs of actinic keratoses are small dry, scaly, or crusty patches of skin. They may be light or dark tan, red, white, pink, grey, flesh-toned, or a combination of colours, and are sometimes raised. Because of their rough texture, actinic keratoses are often easier to feel than see.  

Symptoms may also include bleeding, burning, stinging, itching, pain, tenderness, loss of colour in the lips, or dry, scaly lips. Actinic keratoses that develop on the lip are called actinic cheilitis.  

CAUSES 

The most common cause of actinic keratosis is too much exposure to ultraviolet (UV) light, generally from the sun or indoor tanning equipment, such as tanning beds. The most common precancer of the skin, the Skin Cancer Foundation warned that a patient with one actinic keratosis is likely to develop more in the future. “This puts you at a higher risk for skin cancer since actinic keratosis can develop into squamous cell carcinoma (SCC), a common and sometimes invasive form of the disease.”  

TREATMENT 

Early detection provides the opportunity to treat the lesion and prevent skin cancer before it starts. “When diagnosed promptly, almost all actinic keratoses can be successfully removed,” the Skin Cancer Foundation advised. “Left untreated, some AKs may progress to SCC.”  

Treatment depends on how many AKs the patient has and what they look like. Treatments options include: 

  • Prescription creams and gels: patients may need to use these for up to four months. 
  • Chemical peels: like a medical-grade face mask, the chemicals in the treatment safely destroy unwanted patches in the top layer of skin. While the treated area will be sore and red for the first few days, as the skin heals patients will see a new, healthy layer of skin. 
  • Cryotherapy: this makes the patches turn into blisters and fall off after a few weeks 
  • Excision: prior to surgery to cut out or scrape away the patches, the patient will be given a local anaesthetic, so it does not hurt. Wounds should heal in 2-3 weeks. 
  • Photodynamic therapy (PDT): special cream is applied to the patches and light is shone onto them to kill abnormal skin cells. This treatment is often used in patients with multiple AKs or AKs that return after treatment.