What is Actinic Keratosis - Solar Keratosis
Written by Gary Presant, MD
Sunday, 04 October 2009
Actinic keratosis is a common premalignant skin lesion seen on areas of the body that have been exposed to sun. Premalignant means that the lesions have the potential to become skin cancer.
What is going on in the body?
Sun damage over many years causes changes in the skin. When the cells start to grow in an irregular and unusual fashion, actinic keratosis may develop. The lesions are not true deep or invasive skin cancers, but the area of skin is no longer normal.
What are the causes and risks of the condition?
Actinic keratosis is caused by long-term exposure to the sun. The number of lesions increases with age. A person with light skin has a higher risk of developing actinic keratosis. Someone who works outdoors, such as a lifeguard or construction worker, is at greater risk. Certain antibiotics, such as tetracycline, increase a person's risk.
People with altered immune systems are also at increased risk for actinic keratosis. This group includes:
- people with HIV or other acquired immunodeficiency disorders
- children born with immunodeficiency disorders
- individuals who are taking powerful immunosuppressive medicines after organ transplants
- persons who are taking chemotherapy for treatment of cancer or other disorders
What are the treatments for the condition?
Treatments for actinic keratosis include:
- chemical peeling, which uses trichloroacetic acid or phenol to cause the top layer of skin to slough off
- cryosurgery, which uses extreme cold to destroy abnormal cells
- curettage and desiccation, which involves scraping of the lesion followed by electrocautery to control bleeding
- dermabrasion, which involves sanding off the top layers of the lesion
- laser surgery, which removes the lesions
- shave removal with a scalpel, followed by electrocautery to stop bleeding
- topical medicines, such as 5-fluorouracil or masoprocol, which remove the lesions
What are the side effects of the treatments?
Medicines may cause loss of pigmentation in the treated skin area or allergic reactions. Surgical procedures can cause bleeding, infection, or allergic reaction to anesthesia.
What happens after treatment for the condition?
After treatment, the sites usually heal into smooth skin and are unnoticeable. The person will still have a tendency to develop precancerous lesions. The person should follow skin cancer prevention guidelines for the rest of his or her life.
How is the condition monitored?
A person with actinic keratosis is much more likely to have true skin cancer than most people. He or she should have regular skin checks with the healthcare provider. Any new or worsening symptoms should be reported to the provider.