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Actinic Keratosis

Condition Basics

What is actinic keratosis?

Actinic keratosis is a skin growth caused by sun damage. It can turn into skin cancer, but this isn't common. Actinic keratoses, also called solar keratoses, are small red, brown, or skin-colored scaly patches. They are most common on the face, neck, hands, and forearms.

Your doctor can remove these growths by freezing or scraping them off or by putting medicines on them.

What are the symptoms?

Actinic keratoses are small and noticeable red, brown, or skin-colored patches that don't go away. They most often 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 checked by a doctor, especially if the keratoses become painful, bleed, become open sores, become infected, or increase in size.

How is it diagnosed?

Actinic keratosis is diagnosed through a skin exam. Your doctor may use a bright light or magnifying lens to look for growths, moles, or lesions. The scalp is checked by parting the hair. If there is a chance of cancer, your doctor may take a sample of your skin and test (biopsy) it.

How is actinic keratosis treated?

How is it treated?

Your doctor may recommend one of these treatments:

  • Freezing the skin growth with liquid nitrogen (cryosurgery) to destroy it. Cryosurgery (also called cryotherapy) can cause mild pain that can last up to 3 days. Healing usually takes 7 to 14 days. And there is little or no scarring, though some people with darker skin have lasting 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 abnormal cells that remain. 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 need medical treatment.
  • Shaving the growth with a surgical blade (shave excision). This is done to remove the growth and check the cells for basal or squamous cell carcinoma. Healing usually takes 7 to 14 days. There may be some scarring and changes in the color (pigment) of your skin.
  • Peeling the skin with chemicals (chemical peel). This is done so new skin can grow and replace damaged skin.
  • Resurfacing the skin with laser (laser resurfacing). An intense beam of light from a laser (such as the carbon dioxide or CO2 laser) is used to destroy the top layer of skin. As the treated area heals, new skin grows to replace the damaged skin.
  • Treating the skin with medicines that are put on the skin. These include fluorouracil (5-FU), imiquimod (Aldara), ingenol mebutate (Picato), and diclofenac (Solaraze).
  • Using medicine and light to kill cells (photodynamic therapy, or PDT). PDT uses medicine, such as aminolevulinic acid (ALA). It is put on the skin and then activated with light. The light causes the medicine to destroy the actinic keratosis.

Will it become cancer?

Actinic keratosis may turn into skin cancer, but this isn't common. There is no way to find out whether actinic keratosis will progress to squamous cell carcinoma or how fast this might occur. Keratoses on the ear and lip are at the highest risk of developing into cancer because of how sensitive the ear and lip are to sun exposure.

How can you prevent actinic keratosis?

You can help prevent actinic keratosis by staying out of the sun and using sunscreen when you are in the sun. You should also examine your skin for the condition and other suspicious growths once a month, especially if you spend a lot of time in the sun.

Credits

Current as of: March 3, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Martin J. Gabica MD - Family Medicine
Amy McMichael MD - Dermatology

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