What is Actinic Keratosis?
Actinic keratosis (AK) is a scaly, rough, crusty lesion that forms on the skin in areas exposed to the sun. It most often appears on the lips, face, scalp, ears, shoulders, and other areas frequently exposed. Typically, the areas of skin affected will have more than one lesion, so the plural of this condition is known as actinic keratoses. These lesions develop slowly over time and may disappear and reappear, and be itchy, uncomfortable, and become inflamed. During a thorough skin assessment, our board-certified dermatologists at Snyder Dermatology will analyze the lesion, sometimes utilizing dermoscopy. Even though this skin condition is considered precancerous, it can be a cause for concern if not treated and could develop into a skin cancer. Removal of the lesion will most likely be recommended and discussed during the examination.
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Chronic sun exposure is the main cause of actinic keratosis and it is more prevalent in older individuals from years of sun damage. While only a small percentage of AKs turn into skin cancer, it's important to understand what this skin condition looks like and how to treat it. In most cases, this skin condition shows up as lesions that look red and scaly, as well as bumps and tan crusts that show up in multiple clusters that do not heal. When the condition first appears, it may feel only like rough texture on the skin. Sometimes this area will itch and become irritated. Over time, especially if it is exposed to more sun, the patchy area will turn red, scaly, bumpy, and inflamed and continue to grow. The more keratoses that exist, the chances of developing skin cancer increases. So any of these warning signs should be checked by a board certified dermatologist so that treatment can be provided, and future prevention discussed.
How to Treat Actinic Keratosis
Early intervention and treatment is important so that an isolated actinic keratosis or keratoses does not become skin cancer. The treatment option recommended will vary by patient depending on numerous factors such as the patient's age and health, color of skin, how widespread the condition is, growth characteristics of the lesion(s), location, etc. Some common treatment options include:
Cryosurgery is the method of taking liquid nitrogen and using it to destroy lesions (such as actinic keratosis). The procedure is performed in our office and uses liquid nitrogen via a spray to remove the growth. Most patients are able to leave the office shortly after the procedure.
- Electrodesiccation & Curettage
This is a procedure removes skin lesions by scraping the skin down to the unaffected layer. The procedure eliminates the lesion, as well as underlying tissue and/or pre-cancerous cells that may exist. This treatment causes minor scarring, but it remains a proven and effective substitute for surgery and is used in cases where the growth only affects the top layers of the skin. This is commonly used for hypertrophic (thick) actinic keratosis.
When actinic keratoses are widespread, prescription topical creams, gels or solutions may help improve the area and reduce symptoms, this is also called field therapy. These medications can be especially helpful when combined with other therapies, as they treat both the visible lesions and those not yet seen by the naked eye. A common medication used for treatment is 5-fluorouracil (5-FU), which is an FDA-approved topical chemotherapy. This medication is gently rubbed onto the affected area and lesions twice daily for several weeks. Other medications include Imiquimod cream, diclofenac, Picato® (ingenol mebutate), and other variations of fluorouracil that help reduce the lesion counts with a reduced incidence of scarring and in skin cancer.
- Chemical peels
Our dermatology office offers numerous chemical peel variations that can help remove the unhealthy surface layer and superficial lesions. The chemical agent most commonly used is trichloroacetic acid (TCA). This is applied to the skin, causing the top layers to peel and slough off. New skin regenerates and replaces the damaged tissue.
Plan Your Procedure
- 15 minutes
Schedule Your Consult Today!
If you have lesions that you believe may be related to sun exposure and could possibly be actinic keratosis, we recommend calling our Austin, TX dermatology practice to schedule your consultation. Almost all AKs can be eliminated if caught and treated early. We will provide a thorough analysis of your skin and provide the best possible recommendation for a healthy, long-term outcome.