Actinic Keratosis

A Brief Overview

What is Actinic Keratosis

Also called solar keratosis
Its a rough, scaly, crusty growth (lesion) on your skin
caused by damage from the suns ultraviolet (UV) rays.
It's most commonly found on sun exposed areas of your
body such as your face, lips, ears, back of your hands,
forearms, scalp or neck.
These lesions take years to develop, usually first
appearing in older adults.

Signs and Symptoms of Actinic

Keratosis
Rough, dry or scaly patch of skin, usually less than 1 inch

(2.5 centimeters) in diameter

Flat to slightly raised patch or bump on the top layer of
skin
In some cases, a hard, wart-like surface
Color as varied as pink, red or brown, or flesh-colored
Itching or burning in the affected area

Causes of Actinic Keratosis

Chronic sun exposure is the cause of almost all actinic keratosis. Sun damage
to the skin is cumulative, so even a brief period in the sun adds to the lifetime
total.
Cloudy days arent safe either, because 70-80 percent of solar ultraviolet (UV)
rays can pass through clouds. These harmful rays can also bounce off sand,
snow and other reflective surfaces, giving you extra exposure.
The ultraviolet radiation given off by the lamps in a tanning salon can be even
more dangerous than the sun, so dermatologists warn against indoor tanning.
Occasionally, actinic keratosis may be caused by extensive exposure to X-rays
or a number of industrial chemicals.

Risk Factors for actinic Keratosis

Although anyone can develop actinic keratoses, you may be more likely to develop the

condition if you:
Are older than 40
Live in a sunny climate
Have a history of frequent or intense sun exposure or sunburn
Have pale skin, red or blond hair, and blue or light-colored eyes
Tend to freckle or burn when exposed to sunlight
Have a personal history of an actinic keratosis or skin cancer
Have a weak immune system as a result of chemotherapy, chronic leukemia, AIDS or organ
transplant medications (Also, individuals whose immune defenses are weakened by cancer
chemotherapy, AIDS, organ transplantation or excessive UV exposure are less able to fight off
the effects of the radiation and thus more likely to develop actinic keratoses)

Preventing Actinic Keratosis

The best way to prevent actinic keratosis is to protect yourself from the sun. Here are some sun-safety

habits that really work.

Seek the shade, especially between 10 AM and 4 PM.
Do not burn.
Avoid tanning and never use UV tanning beds.
Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor
activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply
every two hours or after swimming or excessive sweating.
Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
Examine your skin head-to-toe every month.
See your doctor every year for a professional skin exam.

Complications of Actinic
keratosis
If treated early, almost all actinic keratoses can be
eliminated
However, if left untreated, up to 10% of AKs develop into
squamous cell carcinoma (SCC), the second most common
form of skin cancer. (a type of cancer that usually isn't
life-threatening if detected and treated early.)
In rarer instances, AKs may also turn into basal cell
carcinomas, the most common form of skin cancer.

Tests and diagnosis of Actinic

Keratosis
Your doctor can usually diagnose actinic keratosis simply
by looking at it.
If there's any doubt, your doctor may do other tests, such
as a skin biopsy.
During a skin biopsy, your doctor takes a small sample of
your skin for analysis in a lab.
A biopsy can usually be done in a doctor's office after a
numbing injection.

Treatment options for Actinic

Keratosis: Topical Medications
When AKs are numerous and widespread, topical creams,
gels and solutions are especially useful by themselves or
in combination with another form of treatment. They treat
both visible and invisible lesions with a minimal risk of
scarring.
Includes: 5-Fluorouracil cream (Carac, Fluoroplex,
Efudex), miquimod cream (Aldara, Zyclara), Ingenol
mebutate gel (Picato), and Diclofenac gel (Voltaren,
Solaraze)

Treatment options for Actinic

Keratosis: Photodynamic Therapy
In photodynamic therapy, a medicine that makes your
damaged skin cells sensitive to light (photosensitizing
agent) is applied to the affected skin.
Your skin is then exposed to intense laser light to destroy
the damaged skin cells.
Side effects may include redness, swelling and a burning
sensation during therapy.

Treatment options for Actinic

Keratosis: Freezing (cryotherapy)
Used if you have only a few actinic keratoses
An extremely cold substance, such as liquid nitrogen, is applied to skin
lesions.
The substance freezes the skin surface, causing blistering or peeling.
As your skin heals, the lesions slough off, allowing new skin to appear.
Cryotherapy is the most common treatment; it takes only a few minutes
and can be performed in your doctor's office.
Side effects may include blisters, scarring, changes to skin texture,
infection and darkening of the skin at the site of treatment.

Treatment options for Actinic

Keratosis: Scraping (curettage)
Used if you have only a few actinic keratoses
In this procedure, your surgeon uses a device called a curette to
scrape off damaged cells.
Scraping may be followed by electrosurgery, in which a pencilshaped instrument is used to cut and destroy the affected tissue
with an electric current.
This procedure requires a local anesthetic. Side effects may
include infection, scarring and changes in skin coloration at the
site of treatment.

References
http://
www.skincancer.org/skin-cancer-information/actinic-kerato
sis
http://
www.mayoclinic.org/diseases-conditions/actinic-keratosis/
basics/definition/con-20030382