Actinic Keratosis

What is Actinic Keratosis

Actinic keratosis is a precancerous growth on the skin. This means that it could develop into skin cancer if it is not treated. About 1% of these growths (actinic keratoses) turn into skin cancer within one year if they are not treated.

It is important to have all of these growths evaluated to determine the best treatment approach.

What are the causes?

This condition is caused by getting too much ultraviolet (UV) radiation from the sun or other UV light sources.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Having light-colored skin and blue eyes.
  • Having blonde or red hair.
  • Spending a lot of time in the sun.
  • Inadequate skin protection when outdoors. This may include:
    • Not using sunscreen properly.
    • Not covering up skin that is exposed to sunlight.
  • Aging. The risk of developing an actinic keratosis increases with age.

What are the signs or symptoms?

Actinic keratoses look like scaly, rough spots of skin. They can be as small as a pinhead or as big as a quarter. They may itch, hurt, or feel sensitive. In most cases, the growths become red. In some cases, they may be skin-colored, light tan, dark tan, pink, or a combination of any of these colors. There may be a small piece of pink or gray skin (skin tag) growing from the actinic keratosis. In some cases, it may be easier to notice actinic keratoses by feeling them, rather than seeing them.

Actinic keratoses appear most often on areas of skin that get a lot of sun exposure, including the scalp, face, ears, lips, upper back, forearms, and the backs of the hands. Sometimes, actinic keratoses disappear, but many reappear a few days to a few weeks later.

How is this diagnosed?

This condition is usually diagnosed with a physical exam. A tissue sample may be removed from the actinic keratosis and examined under a microscope (biopsy).

How is this treated?

Treatment for this condition may include:

  • Scraping off the actinic keratosis (curettage).
  • Freezing the actinic keratosis with liquid nitrogen (cryosurgery). This causes the growth to eventually fall off the skin.
  • Applying medicated creams or gels to destroy the cells in the growth.
  • Applying chemicals to the actinic keratosis to make the outer layers of skin peel off (chemical peel).
  • Photodynamic therapy. In this procedure, medicated cream is applied to the actinic keratosis. This cream increases your skin’s sensitivity to light. Then, a strong light is aimed at the actinic keratosis to destroy cells in the growth.

Follow these instructions at home:

Skin care

  • Apply cool, wet cloths (cool compresses) to the affected areas.
  • Do notscratch your skin.
  • Check your skin regularly for any growths, especially growths that:
    • Start to itch or bleed.
    • Change in size, shape, or color.

Caring for the treated area

  • Keep the treated area clean and dry as told by your health care provider.
  • Do notapply any medicine, cream, or lotion to the treated area unless your health care provider tells you to do that.
  • Do notpick at blisters or try to break them open. This can cause infection and scarring.
  • If you have red or irritated skin after treatment, follow instructions from your health care provider about how to take care of the treated area. Make sure you:
    • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
  • If you have red or irritated skin after treatment, check your treated area every day for signs of infection. Check for:
    • Swelling, pain, or more redness.
    • Fluid or blood.
    • Warmth.
    • Pus or a bad smell.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
  • Have a skin exam done every year by a health care provider who is a skin conditions specialist (dermatologist).
  • Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

  • Do notget sunburns.
  • Try to avoid the sun between 10:00 a.m. and 4:00 p.m. This is when the UV light is the strongest.
  • Use a sunscreen or sunblock with SPF 30 (sun protection factor 30) or greater.
  • Apply sunscreen before you are exposed to sunlight, and reapply periodically as often as directed by the instructions on the sunscreen container.
  • Always wear sunglasses that have UV protection, and always wear hats and clothing to protect your skin from sunlight.
  • When possible, avoid medicines that increase your sensitivity to sunlight. These include:
    • Certain antibiotic medicines.
    • Certain water pills (diuretics).
    • Certain prescription medicines that are used to treat acne (retinoids).
  • Do notuse tanning beds or other indoor tanning devices.

Contact a health care provider if:

  • You notice any changes or new growths on your skin.
  • You have swelling, pain, or more redness around your treated area.
  • You have fluid or blood coming from your treated area.
  • Your treated area feels warm to the touch.
  • You have pus or a bad smell coming from your treated area.
  • You have a fever.
  • You have a blister that becomes large and painful.
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