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Actinic Keratosis

(AK)

Definition

Actinic keratosis (AK) is abnormal growth of the skin. It results in a rough, scaly, or crusted patch of skin. AK tends to occur on sun-damaged skin.
AK is not cancer but it can sometimes change to squamous cell skin cancer . Treatment includes removing lesions and monitoring for skin cancer .
Actinic Keratosis
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Causes

AK is caused by long term excessive sun exposure.
UV rays from sunlight can cause skin damage. Overtime this damage can cause abnormal growth of the skin such as AK.

Risk Factors

The following factors increase your chances of developing AK:
  • Fair complexion
  • Easy sunburning
  • Extra exposure to sun
  • Occupations or pastimes in sunlight such as farmer, lifeguard, or athlete in outdoor sports

Symptoms

If you have these symptoms, do not assume it is actinic keratoses. There are several skin conditions that have similar symptoms. See your doctor if you notice changes on sun exposed skin such as:
  • Spotted or smeared red, thinning skin
  • Rough, scaly, or crusted patches

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a specialist.
A biopsy of the lesion may be done. The skin will be closely examined for cancer.

Treatment

AK lesions increase your risk of skin cancer. The lesions are usually removed to decrease this risk. Your doctor will also monitor the lesion for signs of cancer.
The exact method of removal will be determined by the number and location of the lesions. Talk with your doctor about the best plan for you.
AK may be removed with:
  • Surgical removal—lesion is scraped or cut out with a scalpel
  • Cryosurgery—a freezing spray that kills abnormal tissue
  • Chemical peel—chemicals can destroy the abnormal tissue on the surface of the skin
  • Photodynamic therapy—chemical is applied to the area and activated by special lights
Medications may also be applied over the skin. More than one treatment may be required. Over time the medication will remove the AK. Medication may be an option for people with multiple AKs. Options include:
  • 5-fluorouracil (5-FU) cream—attacks damaged skin
  • Imiquimod—topical cream
  • Diclofenac gel
The procedures and medications will remove AK and allow healthy skin to grow in its place. Most treatments have some risk of scarring or discoloration of the skin. You and your doctor will talk about risks and benefits.

Prevention

To help reduce your chances of getting AK and skin cancer:
  • Avoid sun exposure.
  • Protect your skin when outdoors. Wear long sleeves, long pants or a long skirt. Use a wide-brimmed hat, especially during the middle of the day.
  • Use sun screen with an SPF of at least 15.

RESOURCES

American Academy of Dermatology http://www.aad.org/

American Osteopathic College of Dermatology http://www.aocd.org/

CANADIAN RESOURCES

BC Cancer Agency http://www.bccancer.bc.ca/

HealthLink BC http://www.healthlinkbc.ca/

References

Actinic keratosis. DynaMed website. Available at: http://www.dynamicmedical.com/dynamed.nsf?opendatabase . Updated May 8, 2012. Accessed January 2, 2013.

Actinic keratosis. The Skin Cancer Foundation website. Available at: http://www.skincancer.org/ak/index.php . Accessed January 2, 2013.

Jeffes EW III, Tang, EH. Actinic keratosis. Current treatment options. Am J Clin Dermatol . 2000;1:167.

Rivers JK, Arlette J, Shear N, et al. Topical treatment of actinic keratoses with 3.0% diclofenac in 2.5% hyaluronan gel. Br J Dermatol . 2002;146:94.

Stockfleth E, Meyer T, Benninghoff B, Christophers E. Successful treatment of actinic keratosis with imiquimod cream 5%: a report of six cases. Br J Dermatol . 2001;144:1050.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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