Actinic Keratosis - Topic Overview
What is actinic keratosis, and what causes it?
Actinic keratosis, also called solar or senile keratosis, is a
precancerous skin condition that develops in sun-exposed skin, especially on
the face, hands, forearms, and the neck. It is seen most often in pale-skinned,
fair-haired, light-eyed people, beginning at age 30 or 40 and becoming more
common with age.
What are the symptoms?
Actinic keratoses are
small and noticeable red, brown, or skin-colored patches that don't go away.
They commonly occur on the head, neck, or hands but can be found on other areas
of the body. Usually more than one is present. They may:
- Have a rough texture.
- Itch, burn, or sting.
- Range in size from 1 mm to 3 mm or larger (about the size of
a small pea).
- Be numerous, with several patches close together.
- Be surrounded by red, irritated skin.
Actinic keratosis needs to be evaluated by a doctor,
especially if the keratoses become painful, bleed, become open sores, become
infected, or increase in size.
How is actinic keratosis diagnosed?
keratosis is diagnosed through a skin examination. Your doctor may use a bright
light or magnifying lens to look for growths, moles, or lesions. The scalp is
examined by parting the hair. If there is a possibility of cancer, your doctor
may take a sample of your skin and test (biopsy)
How is it treated?
Early treatment of actinic
keratosis is recommended to stop the possible progression to a type of skincancer (squamous cell carcinoma). Treatment may
- Freezing the skin growth with liquid nitrogen (cryotherapy) to
destroy it. Cryotherapy can cause mild pain that can last up to 3 days. Healing
generally takes 7 to 14 days, and there is little or no scarring, though some
people with darker skin have permanent skin color lightening. This procedure
can be done in your doctor's office.
- Scraping and using electric current (curettage and
electrosurgery). The skin is numbed, and the growth is scraped off using a
spoon-shaped instrument (curette). After scraping, electrosurgery may be done to
control bleeding and destroy any remaining abnormal cells. Curettage is a quick
treatment, but it can cause scarring. Sometimes a thick scar, or keloid,
develops after curettage treatment. A keloid can be itchy or grow larger over
time but it doesn't require medical treatment.
- Medicines that are put on the skin, such as fluorouracil
(5-FU), imiquimod cream (Aldara), and 3% diclofenac gel (Solaraze).
- Photodynamic therapy (PDT) using aminolevulinic acid (ALA). PDT
is a treatment that uses light combined with a medicine that is put on the skin
(ALA). The light causes the medicine to destroy the actinic keratosis. One
study found that treatment with PDT and ALA left the skin looking better than
treatment with cryotherapy.1
Will actinic keratosis progress to cancer?