About actinic keratosis

What is actinic keratosis?

An actinic keratosis (ak-TIN-ik ker-uh-TOE-sis) is a rough, scaly patch on your skin that develops from years of exposure to the sun. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck.

Also known as a solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin. These patches take years to develop, usually first appearing in people over 40.

A small percentage of actinic keratosis lesions can eventually become skin cancer. You can reduce your risk of actinic keratoses by minimizing your sun exposure and protecting your skin from ultraviolet (UV) rays.



What are the symptoms for actinic keratosis?

The signs and symptoms of an actinic keratosis include:

  • 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, wartlike surface
  • Color as varied as pink, red or brown
  • Itching or Burning in the affected area

Actinic keratoses are found primarily on areas exposed to the sun, such as your face, lips, ears, hands, forearms, scalp and neck.

When to see a doctor

It can be difficult to distinguish between noncancerous spots and cancerous ones. So it's best to have new skin changes evaluated by a doctor — especially if a spot or lesion persists, grows or bleeds.



What are the causes for actinic keratosis?

An actinic keratosis is caused by frequent or intense exposure to UV rays, from the sun or from tanning beds.



What are the treatments for actinic keratosis?

An actinic keratosis sometimes disappears on its own, but it typically returns after more sun exposure. Because it's impossible to tell which patches or lesions will develop into skin cancer, actinic keratoses are usually removed as a precaution.

Medications

If you have several actinic keratoses, you may be better served by treating the entire affected area. Prescription products that can be applied to your skin for this purpose include:

  • Fluorouracil cream (Carac, Fluoroplex, Efudex)
  • Imiquimod cream (Aldara, Zyclara)
  • Ingenol mebutate gel (Picato)
  • Diclofenac gel (Voltaren, Solaraze)

These creams may cause redness, scaling or a burning sensation for a few weeks.

Photodynamic therapy

In photodynamic therapy, your doctor applies a chemical solution to the affected skin that makes it sensitive to light. He or she then exposes the area to artificial light to destroy the damaged skin cells. Side effects may include redness, swelling and a burning sensation during therapy.

Surgical and other procedures

If you have only a few actinic keratoses, your doctor may recommend removing them. The most common methods include:

  • Freezing (cryotherapy). Actinic keratoses can be removed by freezing them with liquid nitrogen. Your doctor applies the substance to the affected skin, which causes 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 done 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.
  • Scraping (curettage). In this procedure, your surgeon uses a device called a curet to scrape off damaged cells. Scraping may be followed by electrosurgery, in which the doctor uses a pencil-shaped instrument 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.



What are the risk factors for actinic keratosis?

Anyone can develop actinic keratoses. But 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 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, leukemia, AIDS or organ transplant medications



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