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Actinic keratosis – Symptoms and causes

Publisher/Author : Pacific Cross

This post is also available in: Tiếng Việt (Vietnamese)

Actinic keratosis

Know the basics

What is actinic keratosis?

Actinic keratosis, also called solar keratosis, is a rough, scaly patch on your skin that develops in sun-exposed skin, especially on the face, hands, forearms, and the neck. It is seen most often in pale-skinned, fair-haired, light-eyed people.

In most cases, actinic keratosis is not cancerous. They are considered “in situ” stage squamous cell carcinoma  lesions which mean the lesions are confined to one location and not invading other tissues.

How common is actinic keratosis?

The closer to the equator you live, the more likely you are to have actinic keratosis. The incidence is slightly higher in men, because they tend to spend more time in the sun and use less sun protection than women do.

However, it can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of actinic keratosis?

Actinic keratosis starts out as thick, scaly, crusty skin patches which are usually about the size of a small pencil eraser. There might be itching or burning in the affected area.

Over time, the lesions can disappear, enlarge, remain the same, or develop into squamous cell carcinoma. There is no way of knowing which lesions may become cancerous.

The signs and symptoms of an actinic keratosis include:

  • Rough, dry or scaly patch of skin, usually less than 2.5 centimeters in diameter
  • Flat to slightly raised patch or bump on the top layer of skin
  • In some cases, a hard, wart-like surface
  • Color as varied as pink, red or brown
  • Itching or burning in the affected area
  • Actinic keratosis is found primarily on areas exposed to the sun, such as your face, lips, ears, hands, forearms, scalp and neck

When should I see my doctor?

It can be quite difficult to distinguish between noncancerous spots and cancerous ones. So it is considered that you should have your skin evaluated by a doctor — especially if a spot or lesion persists, grows or bleeds.

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes actinic keratosis?

There are a great number of causes of this condition; however, long-term exposure to sunlight is considered as one of the most common causes to induce actinic keratosis, which is also called solar keratosis, is a skin growth that develops in sun-exposed skin, especially on the face, hands, forearms, and the neck.

It is seen most often in pale-skinned, fair-haired, light-eyed people, beginning at age 30 or 40 and becoming more common with age.

The ultraviolet radiation given off by the lamps in a tanning salon can be even more dangerous than the sun, so dermatologists warn against indoor tanning.

Occasionally, actinic keratosis may be caused by extensive exposure to X-rays or a number of industrial chemicals.

Risk factors

What increases my risk for actinic keratosis?

You may have a higher risk of developing this condition if you:

  • Are over age 60
  • Live in a sunny climate
  • Have light-colored skin and blue eyes
  • Have a tendency to sunburn easily
  • Have a history of sunburns earlier in life
  • Have been frequently exposed to the sun over your lifetime
  • Have the human papilloma virus (HPV)
  • Have a weak immune system as a result of chemotherapy, leukemia, AIDS or organ transplant medications

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is actinic keratosis diagnosed?

Your doctor will likely be able to determine whether you have an actinic keratosis simply by examining your skin with using a bright light or magnifying lens to look for growths, moles, or lesions.

If there is any doubt, they may do other tests, such as a skin biopsy. During a skin biopsy, your doctor takes a small sample of your skin for analysis in a lab.

Even after treatment for actinic keratosis, your doctor will likely suggest that you have your skin checked at least once a year for signs of skin cancer.

How is actinic keratosis treated?

Almost all actinic keratosis can be eliminated if treated early before they become skin cancers. Various treatment options are available, which depend on the growth’s characteristics and the patient’s age and health.

Some of these strategies increase sun sensitivity, so check with your doctor, and be especially diligent about using sun protection during the treatment period. Common treatments include the following.

  • Freezing the skin growth with liquid nitrogen (cryosurgery) to destroy it. Cryosurgery (also called cryotherapy) can cause mild pain that can last up to 3 days. Healing typically takes 7 to 14 days. And there is little or no scarring, though some people with darker skin have permanent skin color lightening. This procedure can be done in your doctor’s office.
  • Scraping and using electric current (curettage and electrosurgery). The skin is numbed, and the growth is scraped off using a spoon-shaped instrument (curette). After scraping, electrosurgery may be done to control bleeding and destroy any remaining abnormal cells. Curettage is a quick treatment, but it can cause scarring. Sometimes a thick scar, or keloid, develops after curettage treatment. A keloid can be itchy or grow larger over time but it doesn’t require medical treatment.
  • Shaving the growth with a surgical blade (shave excision). This is done to remove the growth and check the cells for basal or squamous cell carcinoma. Healing typically takes 7 to 14 days. There may be some scarring and changes in the color (pigment) of your skin.
  • Peeling the skin with chemicals (chemical peel). This is done so new skin can grow and replace damaged skin.
  • Resurfacing the skin with the laser (laser resurfacing). An intense beam of light from a laser (such as the carbon dioxide or CO2 laser) is used to destroy the top layer of skin. As the treated area heals, new skin grows to replace the damaged skin.
  • Treating the skin with medicines that are put on the skin, such as fluorouracil (5-FU), imiquimod (Aldara), ingenol mebutate (Picato), and diclofenac (Solaraze).
  • Using medicine and light to kill cells (photodynamic therapy, or PDT). PDT uses medicine, such as aminolevulinic acid (ALA), that is put on the skin and then activated with light. The light causes the medicine to destroy the actinic keratosis.

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Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage actinic keratosis?

The best way to prevent actinic keratosis is to protect yourself from the sun. Here are some sun-safety habits that really work:

  • Seek the shade, especially between 10 AM and 4 PM.
  • Avoid tanning and never use UV tanning beds.
  • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
  • Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
  • Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or after swimming or excessive sweating.
  • Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months.
  • Examine your skin head-to-toe every month.
  • See your doctor every year for a professional skin exam.

If you have any questions, please consult with your doctor to better understand the best solution for you.


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