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Actinic Keratosis: Symptoms, Causes, Treatment and Prevention

Actinic Keratosis


Here is an article on actinic keratosis from reliable medical and academic sources. Here we will present the signs and symptoms of an actinic keratosis, causes, treatment, and prevention.


What is the actinic keratosis?

Actinic keratosis or AK is a scaly patch found on sun-damaged skin. It is also known as solar keratosis. It is considered precancerous or an early form of cutaneous squamous cell carcinoma (keratinocyte carcinoma).

These precancerous skin tags are common because many people rarely protect their skin from the sun.


Signs and symptoms of an actinic keratosis 


Actinic keratosis (AK) develops when the skin is severely damaged by ultraviolet rays from the sun or indoor tanning.

The spots usually appear on areas of your body that are often exposed to sunlight, such as your face, hands, arms, ears, scalp and legs.

Actinic keratoses come in many colors. You may see a scaly, pimple-like bump or patch of skin:

  • Red or pink
  • Skin color
  • Grey
  • Yellow
  • Brown or tan
  • White
  • Or a combination of colors

An actinic keratosis can be felt or seen as:

  • Burning or stinging
  • Feeling of pain when touched
  • Pain when wearing clothes, which causes you to feel uncomfortable
  • The injured area bleeds
  • loss of lip color
  • It can feel dry, rough, flaky, or like sandpaper
  • Usually its size is between 1 cm to 2 cm
  • You may feel itchy
  • Feel rough and scaly
  • Appear distorted
  • Horn-like growths that stick out (like an animal's horn)

Causes of an actinic keratosis


People most likely to develop the disease have certain risk factors. A risk factor is anything that increases your risk of developing a disease.

Risk factors for actinic keratoses are:

  • Fair skin (burns easily and rarely tans)
  • Naturally red or blond hair
  • Blue or light colored eyes
  • Intense sun exposure
  • 50 years or more
  • Use a tanning bed
  • You have an organ transplant
  • You have a weakened immune system
  • Albinism skin
  • Dry pigmented skin, Rothnord-Thomson syndrome, or Bloom syndrome
  • Tendencies to freckle or burn when exposed to sunlight

If you notice a rough patch on your skin or cracked lips that won't heal, dermatologists recommend getting it checked out.

If left untreated, some actinic keratoses turn into a type of skin cancer called squamous cell carcinoma.


Actinic keratosis treatment


If you find a spot or lump on your skin that you think might be an actinic keratosis, if you only have one skin patch, your doctor may suggest waiting to see if the patch goes away on its own.

For a small number of people, he or she may recommend frequent skin exams instead of treatment.

The right treatment for you depends on several considerations, including:

  • How much do you have the appearance of the disease on the skin.
  • The location of the disease on your body.
  • What does the disease look like?
  • Have you previously had skin cancer?
  • Your other medical conditions, such as living with a transplanted organ.

You can often complete treatment in one or two office visits. Procedures that dermatologists use to treat include:

1. Surgery using topical application of extreme cold - Cryosurgery

During surgery, a dermatologist freezes the disease. The goal is to make the disease go away after a few days. Some patients need more than one surgical treatment before it goes away.

To freeze the disease, the dermatologist will apply a very cold substance such as liquid nitrogen to the area of the disease.

A dermatologist can do this during your visit while you are awake. Within a few days, these growths will ulcerate and crust over.


2. Chemical peel

A chemical peel is similar to a medical grade face mask. You can't get this type of chemical peel at a salon or from a kit sold for home use.

After a medical chemical peel, the treated skin becomes red, swollen and painful. When the area has healed, you'll see new, healthy skin.


3. Scraping

If you have a very thick actinic keratosis, this may be the best treatment. During this procedure, a dermatologist first scrapes an actinic keratosis from your skin, using a technique called scraping.

Your dermatologist may follow this process with electrodes, which heat the treated area to destroy any remaining disease cells.


4. Photodynamic therapy

This may be recommended for a patient who continues to have a new disease or has a disease that returns after treatment. This procedure is a bit time consuming as it consists of two parts.

 During the first part of the treatment, a solution that makes your skin hypersensitive to light is applied to the affected area. 

You will be sitting in the office with this applied to your skin for 60 to 90 minutes. After that, you will be treated with either a blue or red light.

For 48 hours after your treatment, you will need to avoid being outdoors during the day. UV light, even on a cloudy or snowy day, can cause a dangerous skin reaction.

Most patients with the disease require two treatments of photodynamic therapy, with the second treatment given 3 weeks after the first.


5. Laser resurfacing / Laser surgery

This can remove lesions from the face and scalp, and this may be a treatment option for actinic cheilitis, a cancerous growth on the lips. It works by removing the surface layer of the skin.

 After treatment, the skin will feel inflammation and ulceration. When you heal within a week or two, you see new, healthier skin.


Home treatment for actinic keratosis


If you have several diseases on your skin that you can feel but cannot see, your dermatologist may recommend treatment at home.

When you treat at home, you apply the medication to your skin as directed.

Dermatologist-prescribed medications include the following, all of which are approved by the United States. Food and Drug Administration (FDA) for the treatment of AKs:


1. 5-Fluorouracil (5-FU) Cream

You can apply this once or twice a day for 2 to 4 weeks. It is often a treatment option for the chest, arms or back, but usually not for the face due to the skin reaction it causes.

This is not a treatment option for a pregnant woman. 5-FU can harm an unborn baby.

2. Diclofenac sodium gel

This medication tends to cause less skin reaction than 5-FU, but is still very effective. You will need to apply it twice daily for two to three months.

While using this medicine, you should protect your treated skin from sunlight. A dermatologist can tell you the best way to protect your skin.

3. Imiquimod cream

It can be a good option for the face because you can apply it once (or twice) a week, so you don't get a lot of redness and scaling. 

You may need to apply it for 12 to 16 weeks.   

If 12 to 16 weeks is too long, you may be able to use the medication a little differently. 

You can apply imiquimod every night for two weeks. For the next two weeks, you'll be giving your skin a break. 

Then you apply it again, using it every night for two weeks.


Prevention of actinic keratoses

Here is the self-care dermatologists recommend to their patients with actinic keratoses:

1. Apply sunscreen every day 

Studies have found that when patients use sunscreen every day, they have:

  • Fewer disease
  • Lowest risk of developing rheumatoid arthritis and skin cancer

To get the protection you need, apply sunscreen 15 minutes before going outside.

Sunscreen will provide the following on all skin types that are not covered by clothing when you are outdoors, such as your face, ears, and hands:

  • Broad spectrum protection
  • Has SPF 30 or higher
  • Water Resistant

2. Reapply sunscreen every two hours 

Once you apply sunscreen to your skin, it starts to break down. To stay protected, you need to apply it every two hours.


3. Never try to tan

There is no safe way to tan. Lying in the sun, using a tanning bed or sitting under a sun lamp will do more damage to your skin, increasing your risk of developing more actinic keratoses and skin cancer.


4. Protect your skin with clothing, including a wide-brimmed hat, sunglasses, long sleeves and pants

Clothing gives you extra protection because sunscreen cannot block 100% of the sun's rays.


5. Find shade when you are outdoors

The less UV rays that hit your skin, the safer it will be.


6. Make skin self-examination a habit

Checking your skin for signs of actinic keratosis and skin cancer as recommended by your dermatologist can be lifesaving.


7. Keep all dermatology appointments

During these appointments, your dermatologist will carefully check your skin for signs of keratosis and skin cancer.

Keeping every appointment helps detect skin cancer early when it's most treatable.



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