Actinic Keratosis

Last reviewed by Dr.Mary on August 7th, 2018.

What is Actinic Keratosis?

This is a lesion of the skin that looks like a scaly, rough patch on the lips, ears, face, back of hands, forearms as well as neck. The reason for this condition to develop is intense/frequent exposure to ultraviolet or UV rays normally from the sun.


Actinic keratosis is also known as solar keratosis. This condition grows slowly and normally causes no symptoms or signs other than the small spot or patch on the skin. This lesion takes years to grow normally initially appearing in adults who are older. Many physicians believe this condition to be precancerous since it may grow into a cancer of the skin.

The hazard of actinic keratosis can be lessened by minimizing the exposure to the sun as well as shielding the skin from UV rays.

Actinic Keratosis Causes

Risk factors for these lesions include:

  • Fair skin, green or blue eyes, red or blond hair
  • Daily, long-term exposure to the sun
  • Early in life, multiple and severe sunburns
  • Older age

The main cause of actinic keratosis is concentrated/frequent contact with ultraviolet or UV rays which are normally from the sun.

This lesion will normally begin in the top layer of the skin which is the epidermis. This top layer is extremely thin. It offers a sheet of cells of the skin which serve as protection and this is the layer that the body repeatedly discards.

Usually, the cells of the skin of the epidermis grow in a very orderly, controlled matter. New healthy cells push cells which are older toward the surface of the skin where they expire and are eventually discarded. When the cells of the skin are damaged thru ultraviolet radiation, modifications begin to occur in the color as well as the consistency of the skin causing blotchiness as well as lesions or bumps.

The majority of the harm to cells of the skin is caused from exposure to UV radiation from sunlight as well as tanning beds and lamps. This damage is collective. The more time you spend out in the sun, the greater the possibility of skin cancer. The risk factor enhances more when a large amount of your exposure to the sun occurs at locations or the times of the day when the sun is most extreme.

Actinic Keratosis Treatment

It is not possible to be able to detect which lesions or patches will grow into cancer of the skin. Because of this, actinic keratoses are removed as a safety measure. An individual’s primary care physician will confer on which method of management is appropriate.

Management or treatment options include:

Freezing or cryotherapy

This is when liquid nitrogen is applied to skin lesions. This freezes the facade of the skin, causing first blistering and then peeling. As the skin heals, the lesions will be discarded allowing new skin to appear.

Scraping or curettage

This is a process when the surgeon uses a surgical device known as a curet to graze off damaged cells. This may be followed by electrosurgery which entails an instrument that cuts and destroys the involved tissue with an electrical current.

Chemical peels

This consists of applying one or more chemical solutions to the lesions. These chemicals cause the skin to blister and to then peel, allowing new skin to form.

Ointments or creams

There are several topical drugs which contain fluorouracil which is a chemotherapy medication. These drugs destroy actinic keratosis cells by blocking essential functioning of the cells. There is another treatment option known as Aldara which is a topical cream.

Laser therapy

This is a special laser used to specifically remove the actinic keratoses as well as the affected skin underneath. The process is made comfortable using local anesthesia. There is some scarring as well as pigment loss from this process.

Photodynamic therapy

This process entails an agent that causes the skin cells which are damaged to become susceptible to light. This agent is either applied topically or injected. The skin is then exposed to extreme laser light that destroys the skin cells which are damaged.

Dermabrasion

This is a process where the involved skin is removed by using a quickly moving brush. Local anesthetic is used so that the process is more endurable.

An individual with actinic keratosis needs to speak with their primary care physician about all management options. All procedures have pros and cons, including risk of scarring, side effects, and the number of treatment appointments needed. These lesions are normally very receptive to treatment. After treatment the patient will need to have follow-up visits on a regular basis to check for any new lesions or patches.

Actinic Keratosis Pictures

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