Patient Info

Actinic Keratosis

Actinic keratosis is a precancerous growth on the skin that marks the earliest stage in the development of skin cancer. It appears as a dry, scaly, rough patch on the skin after continuous exposure to sunlight. Sometimes this lesion resembles an animal horn and it is called “cutaneous horn.” It usually forms on the face, scalp, back of the hands, or chest and often affects people with fair complexions.

If left untreated, actinic keratosis may progress to squamous cell carcinoma, a skin cancer that can be fatal. It is very important to consult a dermatologist once you suspect any symptoms of actinic keratosis.

There are several treatment options approved by the U.S. FDA for the treatment of actinic keratosis. Your dermatologist will evaluate and decide which treatment is best for you. Some of the techniques are listed below:

• Chemical peeling
  It is a treatment used commonly to rejuvenate and make the skin look young and is effective in treating actinic keratosis also.
  
  Procedure: The skin is cleansed and one or more chemical solutions are applied to the lesion. The chemicals react on the skin and cause it to peel off. A local anesthetic is applied to keep you at ease during the procedure
  New skin forms gradually to replace the peeled off skin.

• Cryosurgery
  In this procedure, a very cold substance, usually liquid nitrogen, is applied to the lesion. This causes freezing of the surface skin leading to blisters and peeling of the lesion. Healing takes place in 3-6 weeks.

• Curettage with Electrosurgery
  In this procedure, a spoon-shaped instrument called a curette is used to scrape the cells on the surface of the lesion.  This is followed by electrosurgery using a pencil-shaped instrument to cut the affected deeper layer with an electric current.

• Dermabrasion
  A special kind of brush is used to abrade and remove the skin surface until the lesion is eliminated. Local anesthesia is given to reduce the discomfort. Pain medications will be prescribed to relieve the pain and soreness after the procedure.
  
  
• Diclofenac Sodium Gel
  This is a topical medication recommended to be applied over the lesion twice a day for 2 to 3 months. Exposure to the sun must be avoided during this time. This treatment is not an option for pregnant women.

• Imiquimod
  This is an immunomodulator drug which stimulates your body’s defense mechanism to fight against diseases. It is used as a combination therapy with other treatment methods such as cryosurgery and electrosurgery.  Imiquimod skin creams are applied to the affected area for 4-16 weeks. It acts by modifying the immune system to reject the UV-damaged cells in the skin.

• Laser Resurfacing
  This procedure is used for localized lesions such as that occurring on the lips. A laser is used to remove the surface layer of the skin so that actinic keratosis cells are also eliminated. The procedure is done under local anesthesia.

• Photodynamic Therapy
  This is a newer treatment method used to treat actinic keratosis on the face and scalp. A topical medication such as 5-aminolevulinic acid (ALA) is applied to the lesion for about 3-18 hours following which the area is subjected to radiation from a blue light source. At Resnik Institute we treat actinic keratosis with a novel technique Levulan® PDT system. The Levulan® PDT system is an advanced two-step system that combines the application of a unique solution to the skin lesions and exposing the treated areas to a specialized blue light to destroy the lesions.

• Surgical Excision
  Surgical removal is considered only when the lesion appears to be large and thick enough to be resistant to other forms of treatment.  The entire lesion along with some healthy tissue is removed and sent for biopsy to assess for cancer cells.

• Topical Chemotherapy
  A topical chemotherapy agent, 5-Fluorouracil (5-FU), is applied twice daily for 2 to 4 weeks. This agent cause irritation in the sun damaged areas and destroys the actinic keratosis cells.

Considering the fact that actinic keratosis develops because of chronic exposure of skin to sunlight, the best way to prevent is to protect your skin from the harmful sun rays.

Sun-Protection Tips

• Apply sunscreen cream liberally all over your exposed skin before going outdoors.
• Use a sunscreen with a Sun Protection Factor (SPF) of at least 30 and that protects against both ultraviolet A (UVA) and ultraviolet B (UVB) rays.
• While in the sun, apply the sunscreen every two hours.
• Wear protective clothing with long sleeves and pants, a wide-brimmed hat, and sunglasses while going out.
• Try avoiding excessive exposure to sunlight by staying out of sun between 10a.m and 4p.m when the sun rays are strongest.

In addition to these practices, skin products such as retinoids (vitamin A derivatives) may be prescribed by your dermatologist.

See complete Wikipedia article here.

For more information from the American Academy of Dermatology click here.