What is an Actinic Keratosis?

  Actinic keratoses are known as precancerous lesions that appear on the skin. These lesions form on chronically sun damaged skin that has had long term exposure to ultraviolet light from the sun or tanning beds. It is likely that if you develop one actinic keratosis, you will develop more and is also putting you at risk for developing skin cancer. If left untreated, actinic keratoses can form into squamous cell carcinomas.

  Actinic keratoses can appear on any area of the body that has had chronic sun exposure. Most commonly though, they appear on the face, lips, ears, scalps and back of hands. A form of actinic keratosis, called actinic cheilitis, can appear on the lip. 

  They often appear as small, dry, scaly spots or crusty patches. They can be white, pink, red or dark tan colour. Because they tend to be scaly, people often can feel them better than see them. 

  There are several therapies available to treat actinic keratosis including:

Surgical treatments:

If a patient has one or more distinct actinic keratosis, a surgical procedure is used more often to treat them. This can include a chemical peel to remove the outer surface of the skin causing new, fresh skin to form over a 6-week period. Another option is using a curette to scrape off the actinic keratosis followed by cauterization of the tissue to destroy any remaining actinic cells. Lastly, laser therapy can be used to vaporize the actinic keratosis. 

Topical treatments:

Several topical creams and gels can be prescribed that can help with wide-spread actinic keratoses, depending on the patient’s tolerability for downtime. These are applied directly to the visible areas and invisible areas with little risk of scarring the skin. The prescriptions currently available are Efudex, Solaraze, Zyclara, Aldara and Picato. Each one is applied at different intervals and cause different types of reactions on the skin. 

Photodynamic therapy – for diffusely wide spread actinic keratoses on the face and scalp, a topical light-sensitizing cream is applied for a set period of time and then a blue light or red light is applied to the area to destroy any precancerous cells. This therapy is typically complete in one session and does not cause any changes to healthy tissue. 

Liquid nitrogen – cryotherapy is done by applying liquid nitrogen to the actinic keratosis, which causes it to fall off in approximately two weeks, revealing new, healthy skin.