Actinic Keratosis and Skin Cancer

Actinic keratosis, also known as senile keratosis or solar keratosis, is a skin condition where the skin lesions appear thickened, crusty and somewhat scaly. It is not a type of skin cancer. However, it is a premalignant condition which if untreated may progress to skin cancer, especially squamous cell carcinoma. This only occurs in about 20% of cases and the majority of people with actinic keratosis will not develop skin cancer.

Since there is no way of saying who will fall within this 20%, it is important that actinic keratosis is diagnosed and treated as early as possible. As with certain types of skin cancer, excessive sun exposure is one of the most causes of actinic keratosis. Therefor lesions are most commonly found in the sun exposed areas of the body such as the face, lips, ears, forearm, neck, back of the hand, scalp and chest.

What is actinic keratosis?

Actinic keratosis is a skin condition. During the initial stages actinic keratosis do not cause any symptom other than appearance of flat scaly patches on the skin. Gradually the patchy lesion grows into a tough wart-like lesion. This lesion is more common in fair skinned people and usually takes years to develop fully. Due to the risk of skin cancer these lesions are usually removed through freezing, scraping, using chemical peelers, laser therapy and so on. Actinic keratosis can prevented to a large extent by reducing exposure to sun and other sources of UV rays.

Symptoms

Lesions of actinic keratosis develop as flat scaly areas which gradually progress to hard wart-like lesions. Sometimes the lesions may appear rough dry, scaly patches on the skin which progresses to flat spots or raised bumps in the skin. The color of the lesion could be pink to brown but sometimes it may appear flesh colored. The size of the lesion usually varies between 2 and 6 mm. It is possible for some lesions to heal on their own however they may return following additional sun exposure or scratching of that area.

In most of the cases it is difficult to differentiate between a cancerous skin lesion and a non-cancerous one. Therefore certain warnings signs should be noted in order to seek medical attention as soon as possible. If an existing skin lesion suddenly becomes painful, itchy or has a burning sensation, bleeds, becomes scaly or crusty or there is drastic change in shape, size, color or gross appearance of the lesion. While these symptoms are common for many non-cancerous skin diseases, it is important to have it first checked by a doctor before excluding cancer.

Causes

Frequent and excessive exposure to UV rays especially through sun exposure may lead to actinic keratitis. The top most layer of the skin is epidermis which is a very thin layer responsible for protection to the layers below. The cells of this layer are continuously being replaced by new cells in a controlled and orderly fashion but when there is damage to cells by UV exposure various skin lesions may appear. Other than radiation from sunlight, exposure to commercial tanning lamps and beds may also lead to these types of skin lesions.

Treatment

Due to the potential for actinic keratitis lesions to become cancerous, it should be removed once it is diagnosed.  There are various meansof removing the lesions such as:

  • Freezing or cryotherapy where an extremely cold substance like liquid nitrogen is applied to the lesion. It causes blistering or peeling and finally sloughing of the lesions.
  • Scraping where the damaged cells are manually scraped off.
  • Chemical peeling where chemical solutions like trichloroacetic acids are applied on the skin so that the lesion sloughs off.
  • Laser therapy to obliterate the cells.
  • Dermabrasion where the damaged cells are removed by a very fast moving brush

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