Actinic Keratosis

1 What is Actinic Keratosis?

Actinic keratosis, or solar keratosis, is a dry, scaly patch of skin often found in sun exposed areas like the scalp, face, neck and shoulders. They enlarge gradually and is often found in older adults.

It develops due to skin damage caused by exposure to UV rays from the sun.

Actinic keratosis can remain without any other symptoms or signs for several years. In some cases, it may develop into skin cancer.

Minimizing sun exposure or protecting the skin from UV rays are ideal ways to prevent the formation of these precancerous skin patches.

2 Symptoms

The Main Symptom of Actinic keratosis is dry and scaly skin lesion, often measuring an inch in diameter. The patch may be solitary or found in groups. 

Appearance of these patches vary. It may be:

  • Skin colored or reddish in appearance
  • Wart-like with a bumpy surface
  • Flat and thickened in the form of a papule
  • Tender and without any specific symptoms

It is often found in sun exposed areas of the skin like the hands, face, and scalp.

In people with chronic exposure to the sun, keratosis may be found in the upper body, lower limbs and also on the feet.

3 Causes

Frequent exposure to UV rays causes abnormal development of the skin cells, which result in actinic keratosis.

UV ray exposure in tanning salons may also result in these dry, scaly patches. The damage caused by UV rays accumulates over a period of time, resulting in skin damage.

Thus, actinic keratosis is more common among older adults than in younger people. It is also common among people who have poor immunity that may result from age, certain disease conditions or certain drugs.

In some cases, keratosis may result from exposure to X-rays and certain industrial chemicals.

Those who have pale skin and/or blonde hair also have increased chances of developing this skin condition.

4 Making a Diagnosis

Physical examination is the best way to diagnose actinic keratosis.

A doctor may suggest additional tests, such as a biopsy to rule out the chances of squamous cell carcinoma.

A biopsy is generally recommended only if the person is not responding to treatment, is on immunosuppressant medication, or has a high risk of developing skin cancer.

5 Treatment

If the skin patches are not worrisome, doctors may not recommend any specific treatment of Actinic keratosis. However, if there are any changes in the color or structure of the patch, it needs attention.

Patches may be removed if the risk of developing cancer is high, or for cosmetic reasons.

About 10% of the actinic keratosis may develop into skin cancer, hence in most cases removal is suggested.

Surgical treatment

Cryosurgery is one of the most common treatment methods for solar keratosis, particularly when there are a limited number of patches on the skin. The growth of the lesions stop when liquid nitrogen is applied to the area.

Damaged cells in the affected area are also removed using a curet. This is often followed by electrosurgery, in which the affected tissue is removed using an electric current.

Non surgical treatment

When the lesions are multiple and scattered, topical applications like gels, creams, and solutions are preferred. These are either used alone or in combination with other methods.

Less scarring occurs with topical medications. Fluorouracil cream, Ingenol mebutate gel, diclofenac gel, and imiquimod cream are commonly prescribed topical applications for controlling solar keratosis.

Superficial actinic keratosis can also be removed using chemical peels.

Photodynamic therapy is another solution suggested for widespread lesions on the skin.

In this method, a photosensitizing agent is applied on the affected skin and then exposed to laser. It selectively removes the damaged cells, and thus prevents damage to the surrounding tissue.

This therapy is often done in combination with cryosurgery, or with topical applications.

6 Prevention

Limiting exposure to the sun is the best way to prevent skin damage.

This can be done by wearing sunscreen or a hat, and covering hands and legs while outside.

Avoiding tanning beds is another preventive measure as they are also a source of UV rays.

7 Alternative and Homeopathic Remedies

There are several alternative and homeopathic remedies used for Actinic keratosis.

Green tea and milk thistle are known to soothe skin damage and sunburn.

Organic virgin coconut oil is used to remove spots caused by sun exposure.

Cider vinegar is another alternative therapy used for the control of sun burn.

8 Lifestyle and Coping

There are different ways to adapt your lifestyle in coping with Actinic keratosis

Self-help is the best method to control skin damage.

Using sunscreen, wearing a hat, and covering arms and legs, are the best way to avoid sun damage.

Any changes in the structure and color of patches in the skin should be reported to a doctor immediately.

9 Risks and Complications

Skin cancer is the most dreaded complication associated with actinic keratosis.

Early treatment can prevent the process of the disease turning into cancer.

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