Actinic Keratosis

Actinic keratosis, also referred to as sun spots, solar keratosis, and pre-cancerous spots, or AK for short, is a crusty or scaly little spot that occurs on the skin, which can by as tiny as a pinhead to measuring more than an inch in diameter. Actinic keratoses can be the same color as the skin, or reddish, pink, tan, or lighter or darker than the skin. The crusty or scaly surface is rough and dry, and hence can be easier to recognize by touching it rather than by looking at it. Actinic keratoses can be raised or flat and usually occurs on parts of the body that are exposed to the sun such as the face, neck, ears, on the forearms and hands, ears, and lips. On being exposed to the sun, they can often feel tender or prickly, or even itchy. If exposure to the sun is avoided for a few years, most of the actinic keratoses will subside on their own.

What Does the Occurrence of Actinic Keratoses Signify?

The occurrence of actinic keratoses is indicative of the development of the cancer of the skin, and hence is a pre-cancerous condition of the skin. But, the process of turning cancerous takes a number of years, besides very few of the actinic keratoses actually do turn malignant. When they do turn cancerous, the condition is known as squamous cell carcinoma.

This type of cancer is not life-threatening, generally, especially when there is early detection and treatment. In case that is not done, it can result in ulceration, bleeding, and infection, with the ulcers growing large in size and invading the tissues nearby, with chances of them metastasizing, or spreading to other parts of the body.

Damage to the skin by the sun takes a long time to accumulate, often requiring a lifetime of exposure to the sun. Recent exposure to the sun or short periods in the sun usually does not lead to actinic keratosis or them developing into cancer of the skin.

Those whose skin is fair, have gray, blue, or green eyes, and have red or blond hair are more susceptible to developing actinic keratosis, since they have less pigmentation of the skin, which acts as a protective barrier against the sun. Darker skinned people can also be affected if they expose their skin to the sun heavily.

What is the Treatment for Actinic Keratosis?

Prevention can be the best method of treating actinic keratoses, which means limiting being exposed to the sun. However, if actinic keratosis has already occurred, preventive methods can only be a means of not exacerbating it, since radiation from the sun has already caused damage to the skin. But, there are various methods of treatment that are quite effective in treating actinic keratosis, such as:

Cryosurgery: This method involves applying liquid oxygen, either with a cotton-tipped applicator or a spraying device, to the actinic keratosis, which results in the lesions sloughing off. Anesthesia is not required and there is no bleeding involved.

Curettage: A curette is used to scrape off the keratosis, along with cauterization to control the bleeding.

Creams: Creams that contain 5-fluorouracil work by attacking the actinic keratoses directly. Although this treatment can cause the skin to become raw and red and some discomfort from the breakdown of the skin, however it is effective. Aldara, one of the newer medications that stimulates the immune system of the body. Solaraze gel, a non-steroidal medicine, is also quite effective.

Chemical Peels: Acids are applied on the affected area, which causes the top layers of the skin to peel off. New skin usually grows within a week, and the soreness and redness go away within a few days.

Photodynamic Therapy: This method of treating actinic keratosis is comparatively new, involving the injection of a chemical into a blood vessel, which collects in the actinic keratoses, which makes them sensitive to a special kind of light.