What is Actinic Keratosis?
Actinic keratosis also known as solar keratosis is a skin condition in which rough, dry scaly patches appear due to chronic sun exposure. It is a precancerous condition that if not treated can lead to a type of skin cancer called squamous cell carcinoma. Actinic keratosis is most commonly found on the neck, lips, forearms, scalp, face, or back of the arms.
Causes of Actinic Keratosis
Actinic keratosis is mainly caused due to frequent exposure to ultraviolet radiation that damages the DNA of skin cells causing changes in texture and color. Some of the most common risk factors include:
- Fair skin
- Working outdoors
- History of regular sunburns
- Age over 40 years
- Use of tanning beds
- Immunocompromised persons
Actinic keratosis usually appears as one or more rough scaly brown or red patches or bumps, 3-10 mm in size that may be inflamed and have a burning or itching sensation. Horn-like growths may develop on the lesions. They are usually seen on the face but may affect other areas such as the back of the hands and legs. As the condition worsens or progresses towards cancer the lesions may become larger, harder, painful, ulcerated, and may start to bleed. Visit your doctor or a specialist to evaluate any skin changes or bumps that do not resolve on their own.
Diagnosis of Actinic Keratosis
Your doctor will review your medical history and symptoms and inspect your skin lesions. A biopsy may be recommended in which a small sample of the skin tissue is obtained for testing and observation under the microscope to detect any cancerous changes.
Treatment for Actinic Keratosis
If you have a single lesion your doctor may recommend a wait and watch approach to see if the lesion clears on its own. The main goal of treatment for actinic keratosis is to destroy the lesions and reduce scarring. There are several treatments that may be administered. Some are performed under local anesthesia and may result in skin redness and tenderness. The various treatments include:
- Medications: Your doctor will prescribe certain medications like diclofenac gel, fluorouracil cream, and ingenol mebutate gel to help destroy the affected cells.
- Cryotherapy: In this method, liquid nitrogen will be injected into the skin that freezes the tissues turning the patches into blisters that fall off within a few weeks.
- Cauterization: In this technique, heat generated by electric current passing through metal wire electrodes is used to destroy the lesion.
- Microdermabrasion: Also known as particle skin resurfacing, this is a non-invasive, procedure that uses a handheld device or a spray of fine aluminum oxide crystals to remove the outer layer of skin including the lesions.
- Photodynamic Therapy: In this procedure, a special cream will be applied to the skin and exposed to a light source. The light source activates the chemicals thereby destroying the abnormal cells.
- Chemical Peel: This involves the application of a chemical solution on the skin that destroys the topmost layer including the lesions.
- Curettage and Electrosurgery: In this method, a curette will be used to scrape off the lesion. This is followed by electrosurgery, in which electric current is passed through a pencil-shaped instrument that is applied to the skin to destroy the remaining affected tissue and control any bleeding.
- Laser therapy: In this technique, an ablative laser device will be used to destroy the affected patches in the skin and allow new skin to appear.
- Surgical Excision: If cancerous changes are suspected, the lesion may be surgically excised along with a surrounding margin of healthy tissue.
Prevention from Actinic Keratosis
Whether you wish to avoid actinic keratosis or prevent your condition from worsening the following measures can help:
- Apply sunscreen to exposed areas when you are out in the sun
- Avoid sun exposure for a long duration
- Wear hats and clothes with long sleeves that will cover your body
- Wear sunglasses that block UV rays
- Examine your skin regularly
- Avoid sun tanning or using tanning beds
