Actinic Keratosis

What is an actinic keratosis?

Actinic keratoses (AK), also known as solar keratoses, are common crusted skin lesions caused by chronic sun exposure.  Up to 60 % of all people over 40 years of age in the Northern hemisphere develop actinic keratoses. 

Actinic keratoses arise in keratinocytes, cells that make up the upper layer of the skin.  AKs can be the first step leading to squamous cell carcinoma.  About 2-10% of these squamous cell caricnomas can spread internally and are life-threatening.

Actinic keratoses are usually multiple, flat or slightly elevated pink, red, brown or tan-colored skin lesions that have the feel of sandpaper.  They occur on areas of the skin chronically exposed to sun light, such as the face, ears, neck, forearms, lower legs and backs of hands.

Patients often complain that these lesions are sensitive or they sting or burn.

Who gets actinic keratoses?

The likelihood of developing AK increases when you have one or more of the following risk factors:

  • Gender
    •  Men are more likely to develop AK because they tend to spend more time in the sun
  • History of extensive sun exposure
  • History of indoor tanning
  • Personal or family history of skin cancer
  • Age
    • Older people are more likely to develop AK, most likely due to total amount of previous sun exposure.
  • Fair skin
  • Light-colored hair
  • Light-colored eyes
  • Freckling
  • Sun sensitivity
  • Rare genetic disorders, such as albinism and xeroderma pigmentosum

What causes actinic keratoses?

Actinic keratoses are caused by chronic, high-level exposure to sunlight and other forms of UV radiation, such as tanning beds and certain ultraviolet light treatments.

What does an actinic keratosis look like?

Actinic keratoses are usually multiple, flat or slightly elevated pink, red, brown or tan-colored crusted or rough skin lesions on areas of the skin chronically exposed to sun light, such as the face, ears, neck, forearms, lower legs and backs of hands. Lesions develop slowly.  They may disappear and then appear again.  Some AK can bleed.

How are actinic keratoses diagnosed?

Usually AKs are diagnosed by clinical examination.  If a lesion looks suspicious for already having developed into a squamous cell carcinoma, then a skin biopsy will be performed.

Treatment of actinic keratoses

  • Cryotherapy with liquid nitrogen
  • Imiquimod topical therapy (Aldara, Zyclara)
  • Fluorouracil topical therapy (Effudex, Fluoroplex, Carac)
  • Other methods include Solaraze gel, tretinoin, laser treatment, and curettage and electrodesiccation.

Prevention of actinic keratoses

  • Avoid sun exposure between the hours of 10 am and 4 pm
  • Use a broad-spectrum sunscreen with excellent UVB and UVA coverage.
    • Apply the sunscreen at least 20 minutes before going outside
    • Reapply sunscreen every two hours or more often if swimming or sweating
  • Wear sun-protective clothing, a wide-brimmed hat and sunglasses

Summit Medical Group is proud to provide medical, surgical and cosmetic dermatology services to women and men in the Tri-State Area, New York and New Jersey, including the following counties and cities: Essex County, Morris County, Bergen County, Union County, Passaic County, Somerset County and Sussex County, NJ - Livingston, Millburn, Short Hills, West Orange, Berkley Heights, Caldwell, Cedar Grove, Cedar Knolls, Chatham, East Hanover, Englewood Cliffs, Essex Fells, Fair Lawn, Florham Park, Fort Lee, Glen Ridge, Jersey City, Kinnelon, Madison, Maplewood, Mendham, Montclair, Montvale, Morristown, New Providence, North Caldwell, Parsippany, Randolph, Roseland, South Orange, Springfield, Summit, Union, Verona, West Caldwell, Whippany and Westfield, NJ.

 
 
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