Actinic Keratosis

Actinic keratosis (AK), also known as solar keratosis, is the result of prolonged exposure to ultraviolet radiation via sunlight or indoor tanning. It is a small crusty or scaly bump or horn that arises on the skin surface. The base may be light or dark, tan, pink, red, or a combination of these...or the same color as your skin. The scale or crust is horny, dry and rough, and is often recognized by touch rather than sight. Occasionally it itches or produces a pricking or tender sensation. It can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can bleed.

The skin abnormality or lesion develops slowly and usually reaches a size from an eighth to a quarter of an inch (2mm to 4mm) but can sometimes become quite large. Early on, it may disappear only to reappear later. It is not unusual to see several AKs at a time. AKs are most likely to appear on the face, lips, ears, scalp, neck, backs of the hands and forearms, shoulders and back—the parts of the body most often exposed to sunshine.

Actinic keratoses can be the first step leading to squamous cell carcinoma (SCC). Some studies show that ten percent do advance, and 40-60 percent of SCCS begin as untreated AKs.

Click here to see pictures of Actinic Keratoses on the Skin Cancer Foundation website.

Precancerous Growths VS. Early Cancer

The term "precancerous" is used because AKs are more likely to turn malignant than healthy skin. Precancerous growths (lesions) are visible to the naked eye and they look different from normal cells when examined under a microscope. When malignant changes occur to the skin, but the malignant cells haven't spread below the top layer of the skin (epidermis), they are called early cancers, or "carcinoma in situ".

Treatment of Actinic Keratoses

Freezing with liquid nitrogen spray is the most common way to remove AKs.  The skin usually heals within 2-6 weeks with minimal scarring.  If the AK persists the area may be retreated or it may be biopsied to rule out skin cancer. Perscription creams such as imiquimod, 5FU, or diclofenac may be useful.  Applying a sunscreen every morning is a good way to prevent developing AKs.


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Bay Oaks Dermatology
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