Understanding Actinic Keratosis

Understanding Actinic Keratosis | Spectrum Dermatology, Scottsdale

Understanding Actinic Keratosis

You’ve probably heard about common skin conditions like age spots, moles, warts, and rashes, but what about actinic keratosis? It’s also a common skin condition and one that’s treatable at Spectrum Dermatology. Actinic keratosis presents as a scaly spot and is most often found on skin that’s been damaged by the sun’s UV rays. However, it’s critical to treat these “precancerous” lesions, otherwise they have the potential to develop into a cutaneous squamous cell carcinoma.

Keep in mind that squamous cell carcinoma is one of the most common kinds of skin cancers and is not nearly as deadly as melanoma, especially when caught and treated early. When squamous cell carcinoma and its precursor (actinic keratosis) are caught early, a simple in-office biopsy and removal of the lesion is all that’s needed. Actinic keratosis is most often found in people with fair skin and a history of sunburns, those who spend a lot of time in direct sunlight, patients with poor immune systems, those with photoaged skin, and anyone who has lived in the tropics or subtropics.

Do I Have Actinic Keratosis?

Actinic keratosis occurs as a bump that’s composed of abnormal skin cells that develop from DNA damage that may be caused by UVB rays. Some patients have a single spot while others have multiple actinic keratoses. These spots often look flat and thick with a plaque on top of them. They might look like a wart and be white or yellow in color. Other actinic keratoses are the same color as the skin, brown like a mole, or red. Some patients present with a spot that’s scaly or looks like a horn, and in some circumstances the spot might be tender. In other words, actinic keratosis can look and present in many ways, which is why it’s important to see a dermatologist if you suddenly develop a new skin irregularity.

You’ll most often find actinic keratosis on the backs of the hands, the face, and on the scalp for those with little or no hair on the head. If a patient has spent significant amounts of time in the sun or a tanning bed, actinic keratosis might also be on the trunk, tops of the feet, or the arms and legs. An important factor with actinic keratosis is to remember that it’s a lesion that can develop into squamous cell carcinoma—it does not necessarily mean that a patient has this type of skin cancer just yet. The more actinic keratoses a patient has, the more likely they are to develop squamous cell carcinoma. It’s most common for a patient with 10+ actinic keratoses to develop squamous cell carcinoma. If the spot is tender, thick, rapidly growing, or ulcerated, that’s a sign that skin cancer may be present.

Risk Factors with Actinic Keratosis

Actinic keratosis is caused by sun damage, and those with this condition are also at a higher risk of other conditions including actinic cheilitis and other types of skin cancer such as basal cell carcinoma, melanoma, and Merkel cell carcinoma. A dermatologist can quickly diagnose actinic keratosis and sometimes a biopsy will be ordered to ensure squamous cell carcinoma is not present. If a biopsy isn’t necessary but you’d still like to remove actinic keratosis because of cosmetic concerns, there are options.

A dermatologist is capable of removing actinic keratosis and the exact approach will depend on the presentation of the spot and your skin. Options may include cryotherapy with liquid nitrogen to freeze away the spot. Shaving or electrocautery may be recommended to scrape or burn away the spot. An excision completely removes actinic keratosis and often requires stitching. The latter might be an option for a large area or if a biopsy is recommended. If there is a lingering spot or scar after the lesion’s removal, there are dermatology treatments that minimize this appearance such as laser skin rejuvenation.

Preventing actinic keratosis is simple: avoid sun exposure and properly apply a broadband sunscreen to the entire exposed skin every time you’re outside. Reapply sunscreen every 75 minutes. If you suspect you have actinic keratosis, consider it a reminder to stick with a good sunscreen regimen and call Spectrum Dermatology today for a consultation at (480) 948-8400.