Actinic Keratosis FAQs
An actinic keratosis, also known as a solar keratosis, is a common premalignant skin lesion. An actinic keratosis appears as a scaly reddish or tan lesion on the epidermis, or surface layer of the skin.
Such a lesion is typically caused by chronic exposure to sunlight, particularly ultraviolet light and is therefore mainly found on areas of the body most frequently exposed to the sun. An actinic keratosis occurs when the cells that comprise 90 percent of the epidermis, the keratinocytes, change their size, shape or organization in a process called cutaneous dysplasia. This alters the texture of the skin surface and may extend deeper, into the dermis.
What are the symptoms of an actinic keratosis?
An actinic keratosis typically manifests as rough or scaly skin, bumps, mottled patterns or protrusions called cutaneous horns. Typically, actinic keratoses appear on the face, including the ears and lips, or on the neck, arms and hands. The lesions may range in size from a pinpoint to several centimeters in diameter and may be yellow, brown, red or violet in color, and smooth, wrinkled or furrowed in texture.
Is an actinic keratosis a form of skin cancer?
No. An actinic keratosis is a premalignant condition which can signal the possibility that a skin cancer may develop. Since an actinic keratosis is a warning sign that a cancer may develop, it deserves examination by a dermatologist. This is particularly true since an actinic keratosis may, if left untreated, develop into a squamous cell carcinoma, the second-most common form of epidermal skin cancer. Squamous cell carcinomas are malignant skin growths that may, if not treated, metastasize to other parts of the body and potentially prove fatal.
Who is most prone to developing an actinic keratosis?
Most actinic keratosies appear in people aged 40-50, although anyone who has had extended exposure to sunlight, especially those who are light-skinned, is susceptible. In sunny regions, teenagers are routinely diagnosed with actinic keratoses.
Should I see a dermatologist if I have an actinic keratosis?
Yes! In addition to being unattractive from a cosmetic standpoint, as explained an actinic keratosis signals the possible life-threatening danger of a squamous cell carcinoma, and so must be treated as quickly as possible.
How is an actinic keratosis diagnosed?
A surgical biopsy may be performed to determine whether the lesion has become cancerous. The procedure is small and painless and takes place in the doctor's office. A pathology report may not be available for a week or two.
How is an actinic keratosis treated?
Depending on the location and severity of the lesion, an actinic keratosis may be treated in a number of ways. The patient and doctor will decide on methodology in consultation. These may include:
- Cryotherapy, or freezing
- Curettage, or scraping
- Application of creams or ointment
- Chemical peeling
- Photodynaminc therapy using laser light
Can actinic keratosis recur?
Yes. In fact individuals who have had an actinic keratosis are more likely to have another lesion of this type and also more like to develop a squamous cell carcinoma.
What should be done to avoid a recurrence?
Safety requires that the patient who has had an actinic keratosis should stay out of the sun as much as possible. When sun exposure is unavoidable, the individual should wear adequate protection, including sunscreen with an SPF of at least 30, sunglasses, long sleeves and pants whenever possible, and wide-brimmed hats. Tanning parlors should be avoided.
The most important preventative technique is that individuals prone to actinic keratosis should have routine examinations, full body checks, by their dermatologists at recommended intervals.