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Actinic Keratoses 

Actinic Keratoses (or “AKs”), are precancerous lesions that frequently develop in patients with chronic ultraviolet (usually sun) exposure and fair skin. Common locations for these spots include the scalp (of bald individuals), face, ears and forearms. Sometimes they can have a “rough” or “gritty” texture, but quite often they are discovered by a trained dermatology provider without the patient even aware because they do not itch or cause pain.

The presence of these spots indicates a higher chance for the development of skin cancer within the area of the actinic keratoses, in particular squamous cell and basal cell carcinoma. These two cancers are occurring at epidemic proportions, and these warning lesions can help us make a plan to prevent the progression to cancer. At Sunshine State Dermatology and Skin Cancer Center, we want to help you prevent skin cancer with early detection and treatment and keep you in skin that is cancer free.

Because of this, your doctor should be diligent in diagnosing, treating and monitoring actinic keratoses.

Who Is at Risk for Actinic Keratoses?

Although anyone can develop actinic keratoses, some people are more susceptible to them than others. Actinic keratoses occur most commonly in men and women older than 40 who live in a sunny climate, have a history of sun exposure or sunburn, and have pale skin, red or blond hair and light-colored eyes. People with a tendency to freckle or burn in the sunlight, or those who have a history of skin cancer, are also at risk. However, younger people, even those with dark skin, can also develop actinic keratoses if they live in very sunny climates.

Those with weakened immune systems due to an underlying illness, or the use of immunosuppressive medications such as chemotherapy, are also much more likely to develop actinic keratoses.

What are the symptoms of Actinic Keratoses?

Symptoms of actinic keratoses will change with time, but the condition usually starts out as a thick, crusty skin patch that’s about the size of a small pencil eraser. In some cases, you may have itching or burning. Over time, if left untreated, these lesions may develop into skin cancers.

It’s important to contact your doctor if you see changes in any marks on your skin, such as inflammation, rapid growth of the lesion, bleeding, redness or ulceration.

After diagnosing an actinic keratosis, your dermatologist will help you find the treatment that is best for you.

What are common treatments for Actinic Keratoses?

  • Cryotherapy, a treatment that uses liquid nitrogen to freeze the lesion.
  • Excising (cutting) the lesion from the skin.
  • Cauterizing the lesion with an electrical current.
  • Chemical peels, which will kill the affected skin cells.
  • Photodynamic Therapy (PDT), which uses light activated medication to kill the affected skin cells.
  • Immunotherapy, which uses a prescription-only topical cream to remove the lesion.

What is Photodynamic Therapy (PDT)?

Photodynamic Therapy (PDT) is a treatment option for Actinic Keratosis (AK). PDT uses a light-sensitizing drug and a special light to destroy abnormal cells. PDT is useful for treating multiple lesions on the face and scalp. It is not invasive and causes little or no scarring. It is also recommended in the treatment of AK due to its high response rates and superior cosmetic outcome. Other treatment options for AK include destructive therapies, topical medications, and field ablation treatments. However, the best treatment option for you depends on various factors, including the number and location of AK lesions, your overall health, and your personal preferences. It is best to consult with Dr. Greenberg to determine the most appropriate treatment for you.

How can I prevent Actinic Keratoses? 

Since actinic keratoses are caused by sun exposure, reducing your exposure to sunlight is the most effective way to prevent it. Be mindful that sun damage is cumulative over a person’s lifetime, so as our life expectancy increases, so does our risk of actinic keratoses and skin cancer.