Actinic Keratosis

Actinic keratosis (AK) is one of the most common skin conditions that prompts patients to seek care of their dermatologists. AKs are a type of skin damage caused by excessive exposure to UV light from the sun. AKs present as rough and scaly, sometimes raised, growths on the skin. These lesions are most commonly found on the head and neck but can occur anywhere that one has had a lot of sun exposure. Most AKs are asymptomatic and are identified by patients based on the textural change of the skin. On the lips, AKs present as white scaly patches, associated with an occasional itching or burning sensation. It is important to get these treated as untreated AKs can develop into squamous cell carcinomas, a type of skin cancer. As such, AKs are commonly regarded as precancerous lesions.

Causes of Actinic Keratosis:
As is the case with skin cancers, certain populations are at greater risk of developing AKs. AKs are most common in people who have fair skin and hair, freckles, sunburn easily, and spend prolonged amounts of time outside. Medications or genetic conditions that weaken the immune system and/or place individuals at higher risk for skin damage from solar UV rays can also increase the risk for AKs.​

Treatment of Actinic Keratosis:
Most AKs are very easily diagnosed clinically and can be treated via multiple effective and affordable modalities. The treatment is aimed at preventing progression of AK into skin cancer, and generally falls into two categories: spot treatment vs field treatment.

• Cryotherapy: Liquid nitrogen is used to cause a freeze-burn to a localized area on the skin. The treated spots undergo a blistering reaction and are eventually replaced by new, healthier skin.
• Chemical peel: When damage is diffuse, chemical peels are an option for field treatment of a larger affected area. The chemicals applied on skin cause superficial damage to treated skin and help slough the top layer and hence the damage.
• Photodynamic therapy (PDT): A medication that makes precancerous cells preferably sensitive to blue light is applied to areas of diffuse damage, and the blue light is directed at the treatment area in a controlled setting to kill the precancerous cells.
• Laser resurfacing: Lasers can target the top damaged layer and help body replace with new, healthier skin.
• Topical Medications: Prescription chemotherapy creams and immuno-modulators can be used to treat a specific area for defined periods of time to help replace the damaged skin.

Regardless of the treatment used, it is extremely important to use sunscreen regularly and take care of your healing skin after treatment until the damaged skin is replaced by newer, healthier skin. Freshly treated skin is especially sensitive to sun and negligence can cause excessive pain, blistering or even bleeding.