Actinic Keratoses (AKs)

Steven Kern

What is an AK?

What is an actinic keratosis?

“Keratosis” (plural keratosis) refers to a rough scaly spot. An actinic keratosis (sometimes called a solar keratosis) is a rough scaly spot caused by many years of repeated sun. These rough spots remain on the skin even if the crust or scale is picked off.

Why treat actinic keratosis?

Actinic keratoses are not skin cancers. However, they are often referred to as “pre-cancerous” because they may sometimes turn cancerous. It’s a good idea to remove them before this occurs. Since the treatment is much simpler, scars do not result from the treatment of the actinic keratosis. In fact, your skin will look much smoother after they are removed. On the other hand, if you wait too long and a skin cancer develops, a visible scar will result from its surgical removal.

Treatment

Treatment of actinic keratosis requires removal of the defective skin cells. They are usually treated by freezing the spots with liquid nitrogen. Freezing causes blistering and shedding of the sun-damaged skin. Sometimes we’re not sure whether or not the growth has progressed to a skin cancer. When there’s doubt, we cut the growth off and send it for microscopic analysis (biopsy). Healing after removal usually takes two to four weeks, depending on the size and location of the keratosis. Hands and legs heal more slowly than the face. The skin’s final appearance is usually excellent. Occasionally, the frozen spot may appear lighter than the surrounding skin.

When there are many actinic keratosis, a useful treatment is the application of 5-fluorouracil (5-FU). The medication is rubbed on the keratosis for several weeks. These medicines destroy sun-damaged skin cells. After three to five days the treated area starts to turn raw. The applications are continued until your physician determines that you have the needed results. Healing starts when the cream is stopped.

Can I prevent new actinic keratosis from developing?

The number of new spots can be decreased by limiting sun exposure. When exposure is necessary, sunscreen with high SPF (greater than 15) should be used. However, you may continue to develop pre-cancerous lesions due to the many years of sun exposure you have already had. These should be treated.

Elderly persons who totally avoid the sun and who use sunscreen may possibly become Vitamin D deficient (sunlight causes the skin to produce Vitamin D). Therefore, it is wise to drink three glasses of milk per day or to consume the recommended daily allowance of Vitamin D as a nutritional supplement.

What if I develop new spots in the future?

If you have severely sun-damaged skin, this therapy may need to be repeated as often as every 6 months in spite of sun avoidance from now on.

Future recurrences should not be self-treated with left over medication as you may be unknowingly treating skin cancers which should not be treated in this manner. Return to our office for an examination before re-starting treatment.

Actinic Keratosis

What is an actinic keratosis?

“Keratosis” (plural keratosis) refers to a rough scaly spot.  An actinic keratosis (sometimes called a solar keratosis) is a rough scaly spot caused by many years of repeated sun.  These rough spots remain on the skin even if the crust or scale is picked off.

Why treat actinic keratosis?

Actinic keratoses are not skin cancers. However, they are often referred to as “pre-cancerous” because they may sometimes turn cancerous.  It’s a good idea to remove them before this occurs. Since the treatment is much simpler, scars do not result from the treatment of the actinic keratosis.  In fact, your skin will look much smoother after they are removed.  On the other hand, if you wait too long and a skin cancer develops, a visible scar will result from its surgical removal. 

Treatment

Treatment of actinic keratosis requires removal of the defective skin cells.  They are usually treated by freezing the spots with liquid nitrogen.  Freezing causes blistering and shedding of the sun-damaged skin.  Sometimes we’re not sure whether or not the growth has progressed to a skin cancer.  When there’s doubt, we cut the growth off and send it for microscopic analysis (biopsy).  Healing after removal usually takes two to four weeks, depending on the size and location of the keratosis.  Hands and legs heal more slowly than the face.  The skin’s final appearance is usually excellent.  Occasionally, the frozen spot may appear lighter than the surrounding skin.  A SEPARATE INFORMATION SHEET REGARDING LIQUID NITROGEN TREATMENT IS AVAILABLE.   

When there are many actinic keratosis, a useful treatment is the application of 5-fluorouracil (5-FU).  The medication is rubbed on the keratosis for several weeks.  These medicines destroy sun-damaged skin cells.  After three to five days the treated area starts to turn raw.  The applications are continued until your physician determines that you have the needed results. Healing starts when the cream is stopped.  A SEPARATE INFORMATION SHEET IS AVAILABLE ABOUT 5-FU TREATMENT.

Can I prevent new actinic keratosis from developing?

The number of new spots can be decreased by limiting sun exposure. When exposure is necessary, sunscreen with high SPF (greater than 15) should be used.  A SEPARATE INFORMATION SHEET IS AVAILABLE DESCRIBING SUN PROTECTION TECHNIQUES.   However, you may continue to develop pre-cancerous lesions due to the many years of sun exposure you have already had.  These should be treated.

Elderly persons who totally avoid the sun and who use sunscreen may possibly become Vitamin D deficient (sunlight causes the skin to produce Vitamin D).  Therefore, it is wise to drink three glasses of milk per day or to consume the recommended daily allowance of Vitamin D as a nutritional supplement. 

What if I develop new spots in the future?

If you have severely sun-damaged skin, this therapy may need to be repeated as often as every 6 months in spite of sun avoidance from now on.

Future recurrences should not be self-treated with left over medication as you may be unknowingly treating skin cancers which should not be treated in this manner.  Return to our office for an examination before re-starting treatment.

©2011 Park City Dermatology. Last updated March 24, 2011

This information is for general educational uses only. It may not apply to you and your personal medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional.

Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.

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