Actinic Keratosis

Actinic keratosis is the most common pre-cancerous skin lesion, affecting more than 58 million Americans. It develops after over-exposure to UV rays from the sun and/or tanning beds.

What is Actinic Keratosis?

Actinic keratoses are a collection of atypical cells called keratinocytes that develop in the top portion of your skin. They’re often characterized by small, dry, scaly, or crusty patches of skin on the face, mouth, ears, scalp, neck, shoulders, forearms, and the back of the hands. Because actinic keratoses may develop into squamous cell skin cancer, they should be treated. They may also be unsightly or recurring, which frustrates many patients. When diagnosed early, nearly all actinic keratoses can be successfully removed.

Are Actinic Keratoses Dangerous?

In some cases, actinic keratosis can lead to squamous cell carcinoma, which is a common type of skin cancer. Because of this potential transformation, it’s always important to have actinic keratosis evaluated by a dermatologist.

How is Actinic Keratosis Diagnosed?

Actinic keratosis should be diagnosed by a board-certified dermatologist. The diagnosis is made by a close evaluation of the skin using magnification. Sometimes a skin biopsy will be ordered to rule out squamous cell carcinoma.

Symptoms of Actinic Keratosis

A rough, dry, or scaly patch of skin that is red, brown, pink, gray, or flesh-colored
Burning, stinging, itching, pain, or tenderness of the lesion
Dry, scaly lips or loss of color of the lips
Bleeding or crusting of the lesion
Hornlike skin growths
A flat to slightly raised patch or bump on the uppermost layer of skin
A hard, wartlike surface

Risk Factors

Because actinic keratosis is very common, it’s important to be aware of the factors that put you more at risk of developing them. Here’s what to know.

Actinic keratosis develops much more often in individuals who have fair skin.
Actinic keratosis is most common in individuals who are 40 years old and up.
If you already have had actinic keratosis, you’re likely to develop more actinic keratosis lesions in the future.
Geography plays a role. The closer you live to the equator, the more likely you are to develop actinic keratosis.
Those with a weakened immune system are at a higher risk of developing actinic keratosis.

Treatment Options for Actinic Keratosis

There are a few different treatment options for addressing actinic keratoses. The right method for you will be determined by the number of lesions you have, their location, your age, and your health. Options include:

Liquid nitrogen (cryotherapy): Liquid nitrogen is applied to the lesion to freeze the tissue. The lesion will then scab over and fall off after a few days, allowing healthy skin to emerge.
Topical treatments: Topical treatments may be recommended for actinic keratoses. These may be used either alone or in combination with other procedures.
Photodynamic therapy (PDT): A light-sensitizing drug is applied topically, directly onto the skin. After application, there is an “incubation period” that may require a few hours to the next day where it needs to stay on the skin and build within the tumor cells. This process causes the drug to convert into a different chemical that causes the cells to become very sensitive to certain kinds of light. Blue light therapy is then used on the area, which destroys the cells.
Electrodesiccation and curettage: Light curettage uses a spoon-like tool to scrape the lesion away, and electrodesiccation uses an electric current to burn the tissue to control bleeding and destroy any leftover pre-cancerous cells.

Why Choose Greco Dermatology?

If detected early, actinic keratoses can be treated before developing into skin cancer. This is why we encourage you to always keep an eye on your skin and have suspicious growths and lesions checked. Founded by double board-certified dermatologist, Mohs surgeon, and skin cancer specialist Joseph F. Greco, M.D., Greco Dermatology offers specialized skin cancer and lesion clinics, as well as urgent lesion visits to provide immediate access for patients directly or from referring providers. If you’re concerned about actinic keratoses or any other skin lesion, we urge you to schedule a consultation with us today.