Actinic keratosis
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What are Actinic (sun induced) keratoses?
Actinic keratoses (AK), also known as solar keratoses, are rough, scaly patches on the skin caused by excessive exposure to ultraviolet (UV) rays from the sun or tanning beds. They typically develop in sun-exposed areas such as the face, lips, ears, back of the hands, forearms, scalp, or neck.
In the majority of cases, actinic keratoses are benign and settle with treatment. For some patients with a history of lots of sun exposure or immunosuppression (weakened immune system), they will be at higher risk of developing a skin cancer. Some cancers can develop from within actinic keratosis. If a lesion does not heal or becomes painful, bleeding or ulcerated, you should book to see a dermatologist urgently for a consultation.
Symptoms of Actinic keratoses
The symptoms of acne can vary, but typically include:
Rough, Scaly Patches:
- The most common symptom is a rough, dry, or scaly patch of skin that is often less than an inch in diameter. It may feel like sandpaper and can be easier to feel than see.
Red or Pink Lesions
- The patches may appear red or pink. In some cases, they can be flesh-colored or brown.
Flat or Slightly Raised Patches
- The lesions can be flat or slightly raised, often with a rough surface.
Crusty or Peeling Skin
- The patches may become crusty or have a hard, wart-like surface. The skin can also peel or flake off.
Itching or Burning
- Some people experience itching, burning, or tenderness in the affected area.
Lips
- When actinic keratosis occurs on the lips, it is called actinic cheilitis. This condition causes the lips, especially the lower lip, to become dry, cracked, scaly, or have white patches.
Multiple Lesions
It is common for multiple lesions to develop at the same time, especially in areas that have had significant sun exposure.
Treatment Options
Treatment options for actinic keratoses (AK) vary based on the number, size, and location of the lesions, as well as patient preference and overall health. Here are the common treatment methods we provide:
Cryotherapy
- Procedure: Hydrozid® is applied to the lesion, freezing and destroying abnormal cells.
- Effectiveness: Often effective for individual or small numbers of lesions.
Topical Medications
There are several topical treatments that can treat actinic keratoses. They will induce inflammation of and around the lesion to stimulate your immune system to reduce and flake off the abnormal cells. Different treatments will induce varying degrees of redness and discomfort for patients, so during your consultation our Consultant Dermatologist will discuss and agree a treatment option suitable and tolerable for you.
Curettage and Electrosurgery
- Procedure: Involves scraping off the actinic keratosis using a curette (a small, spoon or loop-shaped instrument), then the surface wound is sealed with a heated cautery device to prevent bleeding. The skin heals over a few weeks very like how a superficial burn would heal itself. A small scar might be left, some heal the same colour as surrounding skin, but some heal paler and others darker. We usually recommend regular application of petroleum jelly or a silicon based scar gel during the healing phase.
