What is actinic keratosis?
Actinic keratoses are rough, scaly patches on the skin. The colour can be red, light brown or skin-coloured. They occur on skin that has been heavily exposed to the sun over many years, so they are seen mainly on the face, balding scalps, outer ears and backs of the hands. Most specialists regard actinic keratoses as precursors of squamous cell carcinoma. They are very common: roughly 1 in 3 people eventually develops actinic keratosis.
What causes actinic keratosis?
The cause is prolonged exposure to sunlight. People who have spent a lot of time in the sun for work (gardeners, fishermen, construction workers) or who have often been to sunny holiday destinations have an increased risk. A special form of actinic keratosis is the one that occurs on the lips, called actinic cheilitis.
What are the treatment options?
Actinic keratoses do not go away on their own. The following treatments can be used:
- freezing with liquid nitrogen;
- electrocoagulation (burning with an electrical device);
- CO2 laser treatment;
- photodynamic therapy and daylight photodynamic therapy;
- fluorouracil cream and tirbanibulin ointment — these selectively kill the affected cells and barely damage the healthy skin;
- imiquimod cream — this stimulates the immune system in the skin to clear away the abnormal skin cells.
It should be noted that actinic keratoses usually return over time.
Protection against the sun
If you have actinic keratoses, that is a sign the skin has already been considerably damaged by the sun. Good protection in sunny weather with clothing or a good sunscreen is very important.
Preventing problems from actinic keratosis
People with sun-damaged skin who have developed actinic keratoses have an increased risk of developing squamous cell carcinoma. It is therefore good to keep a close eye on the actinic keratoses yourself and have them treated regularly. Especially when a spot becomes painful or the skin beneath it starts to swell, a squamous cell carcinoma may be developing — it is then certainly important to have the skin checked promptly by a doctor.
When to see a doctor
See a doctor if you have rough, scaly, persistent patches on sun-exposed skin, and promptly if such a spot becomes painful, thickened, tender or starts to swell, which can signal a squamous cell carcinoma.