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Medical Dermatology

Actinic Keratosis

What is an actinic keratosis?

An actinic keratosis is a sun induced precancerous lesion. It appears as a scaly or crusty bump that arises on the surface of the skin. It is most often dry and rough, and sometimes causes itching and tenderness. Many times several keratosis will appear in one area. The base of the lesion may vary in color. It may appear tan, pink, red or skin color. This condition is most common on the face, ears, bald scalp, hands, forearms, lips and neck.

What is the cause of actinic keratosis?

Sun exposure is the cause of almost all actinic keratosis. Individuals who are most susceptible to sunburn such as those with fair skin, blonde or red hair, and blue, green or gray eyes are at greatest risk. It is estimated that one in six people will develop an actinic keratosis in their lifetime. Because cumulative sun exposure increases with years, older individuals are more likely to develop this condition.

Is actinic keratosis dangerous?

Actinic keratosis is a precancerous condition and therefore should be treated seriously. It is estimated that 10% of active actinic keratosis will advance to squamous or basal cell carcinomas. If these lesions are detected and treated in the early stages, they are much less likely to turn into skin cancer. Another form of actinic keratosis called actinic cheilitis appears on the lips and can also evolve into squamous cell carcinoma.

How are actinic keratosis treated?

The decision regarding treatment will depend on the nature of the lesion, as well as the age and health of the patient. Treatments include:

  • Cryosurgery (or freezing)
  • Topical treatments for 1 – 12 weeks (e.g. 5-Fluorouracil, Aldara, Solaraze)
  • Blue light
  • Curettage (or scraping followed by biopsy)
  • Chemical peeling

How do you prevent actinic keratosis?

Protect yourself from the sun. Wear sunscreens and protective clothing. Avoid the sun when possible.

Perform regular skin self-examination and consult a physician if you see or feel a suspicious area.

Schedule a regular visual skin exam by your dermatologist at least once a year, or as directed by your physician.

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