Actinic Keratoses (Solar Keratoses)
Actinic keratoses, also known as solar keratoses, are rough, scaly patches on the skin caused by prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. These lesions are considered precancerous because they have the potential to develop into squamous cell carcinoma, a type of skin cancer.
Illness and Conditions
Actinic keratoses primarily affect sun-exposed areas of the body such as the face, ears, neck, scalp, hands, and forearms. They are more common in fair-skinned individuals and those with a history of significant sun exposure. People over the age of 40 are at higher risk, but younger individuals with intense sun exposure can also develop these lesions.
Symptoms
The symptoms of actinic keratoses include:
- Rough, dry, or scaly patches of skin
- Lesions that may be pink, red, or brownish
- Patches that can be flat or slightly raised
- Itching or burning sensation in some cases
- Lesions typically measure less than 1 inch in diameter
Causes
The main cause of actinic keratoses is cumulative exposure to ultraviolet radiation from the sun or artificial sources such as tanning beds. UV radiation damages the DNA in skin cells, leading to abnormal cell growth and the development of these precancerous lesions. Other risk factors include:
- Fair skin, light hair, and light eyes
- History of sunburns, especially in childhood
- Weakened immune system
- Older age
Diagnosis
Diagnosis of actinic keratoses usually involves a physical examination by a dermatologist. The doctor examines the appearance and texture of the skin lesions. In some cases, a skin biopsy may be performed to confirm the diagnosis and rule out skin cancer.
Treatment
Treatment options for actinic keratoses aim to remove or destroy the abnormal cells to prevent progression to skin cancer. Common treatments include:
- Cryotherapy: Freezing the lesion with liquid nitrogen to destroy abnormal cells.
- Topical medications: Creams or gels such as 5-fluorouracil, imiquimod, or diclofenac that target and eliminate precancerous cells.
- Photodynamic therapy: Applying a photosensitising agent to the skin followed by exposure to a specific light source to destroy damaged cells.
- Laser therapy or chemical peels to remove affected skin layers in some cases.
Regular follow-up is essential to monitor for new lesions or recurrence.
Prevention
Preventing actinic keratoses largely involves protecting the skin from UV radiation:
- Use broad-spectrum sunscreen with SPF 30 or higher daily, even on cloudy days.
- Wear protective clothing, hats, and sunglasses when outdoors.
- Avoid tanning beds and prolonged sun exposure, especially during peak hours (10 a.m. to 4 p.m.).
- Regularly check the skin for new or changing lesions and consult a dermatologist for routine skin exams.
Early detection and treatment of actinic keratoses are critical to reducing the risk of progression to skin cancer and maintaining healthy skin.
