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Actinic Keratosis (AK)

MEDICAL DERMATOLOGY

Actinic Keratosis (AKs) are very common skin lesions that form as a result of years of exposure to ultraviolet (UV) light from the sun and tanning beds, AKs are also called “Solar Keratoses”. The UV light causes damage to the skin cells and the skin becomes rough and scaly which often causes the skin to feel like sandpaper. AKs are considered precancerous and if left untreated can progress into a type of skin cancer called Squamous Cell Carcinoma.

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Growth Patterns


Not all AKs look the same. They can cover large areas of the skin, appear in groups as rough scaly patches, they can vary in color and at times they can grow very rapidly and resemble a horn (cutaneous horn). Often, AKs can disappear for weeks or months however they usually return which makes it more important to have these lesions treated to prevent the development of skin cancer.


Common areas where AKs occur are face, bald scalp, ears, arms, hands, chest, back, neck and lower legs. Individuals 40 years and older, with fair skin or skin that freckles or burns easily, light eyes, blonde or red hair are at increased risk of developing AKs.



Treating Actinic Keratosis


There are multiple treatment options for AKs including cryosurgery: freezing the AK which causes the sun damaged skin to flake off and new healthy skin forms as the treated area heals. Prescription topical treatments include the topical chemotherapy based medication 5-Fluoruracil cream which directly kills sun damaged cells, and Imiquimod cream, which stimulated the immune system to attach and destroy pre-cancers. Photodynamic therapy is a new treatment that offers much faster results that seen with traditional topical creams. After a 1-2 hour application of a sensitizer call Levulon, patients spend 15 minutes under a special light called the Blu-U which activates the Levulon to kill sun damaged cells and leave normal skin unharmed. Alternatively, red light therapy may be employed as the longer wavelength can penetrate deeper into the skin.


With the development of AKs you should be under the care of a dermatologist for regular checkups. Most people who develops AKs often continue to get new AKs that will need to be treated to prevent development into skin cancer.



Prevention


You can prevent AKs by protecting your skin from the sun and UV light. Using a broad-spectrum sunscreen with SPF 30 or higher, seek shade and avoid sun exposure between the hours of 10:00 AM and 2:00 PM, wear protective clothing and wide-brimmed hats and sunglasses when possible. Do not use tanning beds. It is best to perform self-skin exams often and contact your dermatologist if you notice a growth that itches, bleeds or has changed in shape, size or color.

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