Definition: is a rough and scaly patch on the skin that develops from years of exposure to the sun.
It is most commonly found on the face, lips, ears, back, hands, forearms, scalp or neck. Also known as solar keratosis, an actinic keratosis enlarges slowly and usually does not cause any signs or symptoms other than a patch or a small spot on the skin.
These patches take years to develop, usually appear for the first time in people over 40 years.
A small percentage of actinic keratotic lesions can eventually develop into skin cancer. The risk of actinic keratosis can be reduced by minimizing sun exposure and protecting the skin from ultraviolet (UV) rays by using a sunscreen.
The signs and symptoms of an actinic keratosis include:
- Patch of rough, dry or scaly skin, usually less than 1 inch (2.5 centimeters) in diameter.
- Flat or slightly raised patch or protrusion in the upper layer of the skin.
- In some cases, a hard surface, similar to a wart.
- Color as varied as pink, red or brown.
- Itching or burning in the affected area.
Actinic keratosis is found mainly in areas exposed to the sun, such as the face, lips, ears, hands, forearms, scalp and neck.
When to see a doctor
It can be difficult to distinguish between non-cancerous and cancerous spots. So it is better to have the evaluation by a doctor – especially if a point or injury persists, grows or bleeds.
An actinic keratosis is caused by frequent or intense exposure to UV, sun or tanning beds.
Anyone can develop actinic keratosis. But you may be more likely to develop the condition if:
- You are over 40 years old.
- Live in a sunny climate.
- Have a history of frequent or intense exposure to the sun or sunburn.
- Have red or blond hair, and blue or light colored eyes.
- Have freckles or burns when exposed to sunlight.
- Have a personal history of actinic keratosis or skin cancer.
- Having a weak immune system as a result of chemotherapy, leukemia, AIDS or organ transplant medications.
If treated early, almost all actinic keratosis can be cleared or eliminated before they develop into skin cancer.
If left untreated, some of these spots can progress to squamous cell carcinoma, a type of cancer that is usually not fatal if it is detected and treated early.
The doctor will probably be able to determine if you have an actinic keratosis simply by examining the skin.
If there is any doubt, he or she can do other tests, such as a skin biopsy. During a skin biopsy, the doctor takes a small sample of the skin for analysis in a laboratory.
Usually, a biopsy can be done in a doctor’s office after an anesthetic injection.
Even after treatment for actinic keratosis, the doctor is likely to suggest that the skin be checked at least once a year for signs of skin cancer.
An actinic keratosis sometimes goes away on its own, but usually returns after more exposure to the sun.
Because it is impossible to determine which patches or lesions will become skin cancer, actinic keratosis is usually eliminated as a precaution.
Doctors can prescribe medications such as:
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- Crema de fluorouracilo (Carac, Fluoroplex, Efudex).
- Imiquimod crema (Aldara, Zyclara).
- Ingenol mebutate gel (Picato).
- Diclofenac gel (Voltaren, Solaraze).
These creams can cause redness, peeling or a burning sensation for a few weeks.
In photodynamic therapy, the 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 damaged skin cells.
Side effects can include redness, swelling and a burning sensation during therapy.
Surgical procedures and other procedures
If you have only an actinic keratosis, the doctor may recommend its removal. The most common methods include:
Freezing (cryotherapy) . Actinic keratosis can be eliminated by freezing them with liquid nitrogen. The doctor applies the substance to the affected skin, which causes blistering or peeling.
As the skin heals, the lesions break off, allowing new skin to appear. Cryotherapy is the most common treatment. It takes only a few minutes and can be done in the doctor’s office.
Side effects can include blisters, scars, changes in skin texture, infection and darkening of the skin at the treatment site.
Scraping (curettage) . In this procedure, the surgeon uses a device called a curette to scrape the damaged cells.
The scraping can 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 can include infection, scars and changes in skin color at the treatment site.
The prevention of actinic keratosis is important because the condition may precede cancer or be an early form of skin cancer.
Sun safety is necessary to help prevent the development and recurrence of patches and spots of actinic keratosis.
Take these steps to protect your skin from the sun:
Limit the time in the sun. Especially avoid the time in the sun between 10 am and 2 pm And avoid staying in the sun for a long time, especially if you do not wear sunscreen.
Both result in skin damage that can increase the risk of developing actinic keratosis and skin cancer. Exposure to the sun accumulated over time can also cause actinic keratosis.
The daily use of sunscreen reduces the development of actinic keratosis. Before spending time outdoors, apply a broad spectrum sunscreen with a sun protection factor (SPF) of at least 30.
The American Academy of Dermatology recommends using a water-resistant broad-spectrum sunscreen with an SPF of at least 30.
Use sunscreen on all exposed skin and use a lip balm with sunscreen on the lips. Apply sunscreen 15 minutes before sun exposure and reapply it every two hours or more often if you swim or sweat.
For additional protection from the sun, wear tightly woven clothing that covers the arms and legs.
Also wear a wide-brimmed hat, which provides more protection than a baseball cap or golf visor.
You can also consider using outdoor clothing or equipment specially designed to provide sun protection.
Avoid tanning chambers. Exposure to UV rays from a tanning chamber causes as much damage to the skin as a tan acquired by the sun.
And because the radiation from a tanning bed is absorbed in a short time, the photo-aging process accelerates and increases the risk of skin cancer.
Check the skin regularly and report noticeable changes to your doctor. Examine your skin regularly, seeking the development of new skin growths or changes in existing moles, freckles, bumps and birthmarks.
With the help of mirrors, check your face, neck, ears and scalp. Examine the top and bottom of the arms and hands.