Actinic keratosis

Actinic keratosis is a scaly lesion or a lesion with crust formed over it. It most often occurs in the bald part of the head, the face, the ears, the back of the hands and the forearms, the shoulders, the neck and the other parts of the body often exposed in the sun. Another form of the actinic keratosis is actinic cheilitis (it affects the lips). The higher the number of keratoses in a person the higher the risk that some of them will become cancer.

Initially, actinic keratosis can only be felt by palpation, being very small in size. Their texture is similar to the texture of abrasive paper. Often they grow so slowly and they can reach 3-6 mm in diameter. They can disappear spontaneously in early stages only to reoccur later.

If you have actinic keratoses, this is an indication that you have suffered UV damage and this increases the chances to develop any kind of skin cancer.
Actinic keratosis is also known as precancer since it is often the first stage towards Squamous Cell Carcinoma (SCC). However, 90% of cases remain benign and almost 10% progress to Squamous Cell Carcinoma.

Actinic keratosis mostly affects fair-skinned people, with blond or red hair and light-colored eyes (blue, grey or green) that have been exposed to solar radiation for very long periods of their lives. Men tend to be more affected than women because they spend more time under the sun with little or no anti UV protection compared to women.

Chronic long-term exposure to the sun is the cause of nearly of actinic keratoses. Damage due to exposure to solar radiation (UV ultraviolet radiation) is cumulative and occurring throughout a person’s life. That is why actinic keratoses occur more frequently in people over 50. The UV radiation used in the solarium centres can be even more harmful than the sun and therefore dermatologists warn against it.

As mentioned, actinic keratosis may result in skin cancer. Yet, one cannot know which cases will progress to skin cancer. Certainly, there is a huge number of treatments that eliminate cancerous keratosis. Before selecting the treatment of choice, the Dermatologist will perform a biopsy to establish whether the lesion is malignant or not.

Actinic keratosis can be treated with:
• Pharmaceutical creams and solutions (used alone or in combination with other forms of treatment, mainly in the cases of numerous lesions)
• Cryosurgery (for a lower number of lesions)
• Combination therapy
• Chemical peeling
• Laser ablation
• Photodynamic therapy (PTD)