Actinic Keratosis

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KEY POINTS

• Actinic keratosis is an abnormal growth of cells on the skin that is exposed to the sun.
• You may need cryotherapy, medicine, surgery, or a combination of these treatments.
• Protect your skin by staying out of the sun and using sunscreen to help prevent actinic keratosis, and while you receive treatment.

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What is actinic keratosis?

Actinic keratosis is a growth of abnormal cells on the skin. It is not cancer, but may turn into cancer. It is most commonly found on areas of the skin that are exposed to the sun, like the head, face, neck, hands, and arms. It is also called solar keratosis.

What is the cause?

Exposure to UV rays from sunlight or tanning beds is the most common cause of actinic keratosis. You may be at higher risk if:

• You have fair skin that freckles or burns easily
• You have red or blond hair and blue or light colored eyes
• Are older than 40
• You spend a lot of time outside, for example, while farming, working, swimming, hiking, or skiing, or driving several hours a day with your arm out the window
• You have a history of frequent or intense sun exposure or sunburns
• You live in a sunny climate, at a high altitude, or in a tropical area
• You have a weakened immune system as a result of chemotherapy or chronic diseases such as AIDS

What are the symptoms?

Actinic keratosis can happen anywhere on the body. Symptoms may include rough, scaly, bumpy areas of skin that form on sun-exposed areas that do not go away. The areas may look red or brown. They may be itchy or tender and could bleed.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may need a biopsy, which is a procedure that removes all or part of the skin growth for lab tests.

How is it treated?

Actinic keratosis is treated by removing or destroying the growths. Treatment helps prevent the growths from becoming skin cancer. It can also treat your soreness and make your skin look better after it heals.

Your healthcare provider may refer you to a dermatologist, who is a skin specialist. You may receive treatment in your healthcare provider’s office or be given medicines that you can use at home.

Treatments may include:

• Cryotherapy is freezing the growths with liquid nitrogen. This therapy may be used when you have a few actinic keratosis spots.
• Creams or gels on your skin may be used when you have many growths on many areas of your body. The medicines make your skin peel and get crusty before it heals.
• Photodynamic (light) therapy uses medicine and special lights to treat your actinic keratosis growths.
• Chemicals may be applied to your skin to make it peel.
• Laser surgery to remove the skin that has actinic keratosis growths.

You may have more than one kind of therapy. You may need to get care from a dermatologist, who is a healthcare provider specializing in skin problems.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Avoid exposing your skin to too much sun, especially while you are being treated for actinic keratosis.

See you healthcare provider for regular exams so that he or she can check your skin.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent actinic keratosis?

• Don’t use sunlamps or tanning beds.
• Avoid exposing your skin to too much sun.
• When you are outdoors:
  • Wear clothing and hats that cover you, and stay out of the midday sun as much as possible.
  • Use sunscreen every day. The higher the sun protection factor (SPF) of the sunscreen, the more your skin is protected. Use a product with an SPF of at least 30. For water sports, use a sunscreen lotion that does not wash off in the water. If you are allergic to PABA, use PABA-free sunscreen lotion. And remember that UV rays from the sun can cause sunburn or damage even on cloudy days. Also protect your lips with a product that contains sunscreen.
• Be especially careful if you are at high altitude, traveling in the tropics, or if the sun's rays are being reflected by water, sand, snow, or concrete.
• Check your skin head to toe very month, and report any changes to your healthcare provider right away. If you are at high risk for skin cancer, see your provider for exams as recommended.