Actinic keratosis (AK) is a common skin condition that serves as an early warning sign of skin cancer. In fact, about 58 million Americans have one or more spots of actinic keratosis! This condition shows up as rough, scaly patches or bumps on the skin. It is primarily caused by prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. While AK is not life-threatening on its own, it can potentially develop into squamous cell carcinoma (SCC), a type of skin cancer. Understanding what actinic keratosis is, how it forms, why it is dangerous, and what actions to take if you notice it is crucial for maintaining skin health.
What is Actinic Keratosis?
Actinic keratosis, also known as solar keratosis, is a rough, scaly patch or bump on the skin. These patches are often more easily felt than seen and can be red, tan, white, pink, or skin-colored. They commonly show up on sun-exposed areas such as the face, ears, scalp, neck, forearms, and lips. Over time, repeated exposure to UV rays damages the skin, leading to the development of these lesions.
How Does Actinic Keratosis Form?
The primary cause of actinic keratosis is cumulative UV exposure. This means that even short, regular periods of sun exposure without protection can add up over the years, causing damage to the skin cells. The skin’s natural defense mechanisms try to repair this damage. Sometimes abnormal cells grow and multiply, forming AK lesions.
People with fair skin, light-colored hair, and light-colored eyes are more susceptible to UV damage and, therefore, to actinic keratosis. Obviously, anyone who is exposed to UV radiation more often is also at a higher risk. This can be someone who works outside, or people with a bald scalp and thinning hair. Other risk factors include:
- Age: Older adults are more likely to develop actinic keratosis due to more extended sun exposure over their lifetime. It is most common in people over 40.
- Immune suppression: People with weakened immune systems from diseases of medications are at higher risk.
- Location: People who live closer to the equator are more likely to have actinic keratosis.
Why is it Dangerous?
Although actinic keratosis itself is not cancerous, it is considered a precancerous condition. This means that if left untreated, there is a risk that AK can develop into squamous cell carcinoma (SCC). SCC is a common form of skin cancer that can be locally invasive and, in some cases, life-threatening if it spreads to other parts of the body.
The likelihood of actinic keratosis progressing to SCC is relatively low, with estimates suggesting that only 5-10% of AK lesions become cancerous. However, because most SCCs begin as actinic keratosis, early detection and treatment are essential to prevent the progression to skin cancer.
Preventing Skin Cancer
If you observe any rough, scaly patches or bumps on your skin, especially in sun-exposed areas, it is important to talk to a dermatologist. Here’s what you can expect during the diagnosis and treatment process:
- Diagnosis: A dermatologist can often diagnose actinic keratosis by examining and feeling the affected area. In some cases, a skin biopsy may be performed to rule out skin cancer.
- Treatment Options: Several effective treatments can remove or destroy lesions.
- Cryotherapy: Freezing the lesion with liquid nitrogen.
- Topical Chemotherapy: Applying medication directly to the skin to destroy abnormal cells.
- Laser Surgery: Using laser technology to remove lesions, particularly on the face and scalp.
- Chemical Peel: A medical-grade chemical peel can be used to destroy the top layers of skin. This is not something you can get from a salon or from a kit sold for at-home use.
- Follow-Up: Regular skin exams are crucial after treatment to monitor for new lesions or skin cancer. Protecting your skin from further UV damage is also vital. Wear sunscreen with broad-spectrum protection and a high SPF. You should try to wear protective clothing, hats, and sunglasses. Find shade and avoid both peak sun hours and tanning beds.
Actinic keratosis is a common but serious skin condition that has the potential to lead to skin cancer. Early detection and treatment are key to preventing AK from progressing. Protecting your skin from UV radiation and seeking regular dermatological check-ups are important steps in maintaining healthy skin and reducing the risk of skin cancer.