Actinic Keratosis

Actinic Keratosis presents as a crusty, scaly growth caused by skin damage from exposure to ultraviolet (UV) radiation. If left untreated these can develop into a skin cancer, usually a squamous cell carcinoma (SCC).

Actinic Keratoses are commonly found on skin that has frequently been exposed to the sun or artificial UV light, like tanning beds. These areas include the face, scalp, ears, shoulders, neck and the back of the hands and legs. Actinic Keratosis are typically mildly elevated, rough in texture and frequently felt by touch more than seen. Color can vary from light or dark tan, white, pink or flesh tone, but most will become red over time.

Early treatment is the best course of action to prevent the development of skin cancer. If your doctor suspects the lesion may be precancerous they will likely freeze the lesion with liquid nitrogen, prescribe a topical treatment, or perform a biopsy if thickened to ensure it has not progressed to a skin cancer. Treatment options include:

  • Freezing off or cryosurgery – liquid nitrogen is applied to freeze off the tissue; the lesion will look worse and become more inflamed for one to two weeks before healing

  • Topical treatments – for cases where there are several AKs spread across larger areas, field treatment with 5-fluorouracil, imiquimod, ingenol mebutate, and calcipotriene can be used

  • Photodynamic treatment – this in-office field treatment uses a photosensitizing agent that is applied to the affected area for 1-3 hours and then the patient is exposed to blue or red light which destroys precancerous cells

  • Laser or light treatment – fractional laser or intense light can be used to treat precancerous skin

  • Chemical peels – this technique can remove actinic damage on the face with acid

Cumulative sun exposure is the leading cause of actinic keratoses, and people with fair skin, freckles, light eyes, blonde or red hair are most vulnerable. Sun protection is critical in preventing the development of this condition.