Actinic Keratosis
What is actinic keratosis?
Actinic (ac-TIN-ik) keratosis (ker-ah-TO-sis), also called solar keratosis, is a type of precancerous skin disease. Precancerous means that it may lead to cancer. Normally, cells reproduce by splitting in a planned way, making more cells only when needed. With actinic keratosis, abnormal cells are found on the outer layer of skin. They grow and divide without order, often making a lesion (lump or bump that is dry, scaly, or rough). Actinic keratosis is found more often in fair-skinned, light-haired people who have been in the sun a lot.
What causes actinic keratosis?
The main cause of actinic keratosis is being out in the sun too much and too often. This includes working outdoors a lot or living near the equator (place on earth that is closest to the sun). The following factors and conditions may also increase your risk of having actinic keratosis:
Age:
Advanced age, particularly in people over 40 years of age.
Use of tanning beds:
Tanning booths and sun lamps release man-made ultraviolet (UVA and UVB) rays that may damage the skin.
Weak immune system:
Having chemotherapy, organ transplants, or acquired immunodeficiency syndrome (AIDS) may cause you to have a weak immune system. The immune system is the part of your body that fights infection.
Other skin diseases:
These include xeroderma pigmentosum, human papilloma infection, skin ulcers, or burn scars.
What are the signs and symptoms of actinic keratosis?
Actinic keratosis may be the first sign of skin cancer. You may have a small, scaly bump or lump on the skin that has been sunburned before. It may occur as a single lesion or as many lesions of different sizes. Most of these bumps are found on the face, lips, ears, scalp, neck, back of the hands, or arms. You may also have any of the following:
Early symptoms:
You may have dry, scaly, or rough skin lesions. These lesions feel like sand paper and may be colored pink, red, brown, or be the same color as your skin.
Later symptoms:
The skin lesions may become hard, crusty, and wart-like. These may look like little animal horns and become itchy or painful. They may become ulcers (sores) and easily bleed when touched or poked.
Let your caregiver know if you notice any skin changes on your body. The earlier an actinic keratosis is found, the better your chances are for being cured.
How is actinic keratosis diagnosed?
Your caregiver will take a detailed health history from you. This may include information on what your skin lesion first looked like and when it started. You may also be asked to give information about your past diseases, sun exposure, activities, injuries, and medicines. You may also need the following:
Physical exam:
Your caregiver will do a complete physical exam on you. He may carefully look at your skin lesions. This will help your caregiver to know what your skin problem is.
Skin biopsy:
A skin biopsy may be needed to diagnose actinic keratosis. This is done by having a small piece of the lesion removed from your skin. The sample is sent to a lab for tests to see if abnormal cells, such as cancer cells, are present.
How is actinic keratosis treated?
You may need any of the following:
Medicines:
Non-steroidal anti-inflammatory medicines:
These medicines are also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling).
Topical chemotherapy:
Chemotherapy is often called "chemo". The word topical means it is put on the skin as a lotion or cream. This medicine is used to treat cancer that is in the outer layers of the skin. Topical chemotherapy is put on to kill cancer cells. While being treated, your skin may hurt and look very red.
Surgery:
Cryosurgery:
During cryosurgery, a chemical called liquid nitrogen is put on the area to be removed. This freezes and kills the tissue. The dead tissue later falls off. Once the tissue thaws, the area may hurt and swell for a short time. You may need cryosurgery more than once.
Electrodessication and curettage:
The skin lesion is scraped and then heated with an electric probe to kill the abnormal cells.
Excision surgery:
This is a surgery to remove all or part of your skin lesion.
Other procedures:
Chemical peeling:
Certain chemical solutions, such as acids, are used to peel the rough skin off. This may make your skin smoother and softer.
Dermabrasion:
Special tools, such as a scrub brush, dermatome, or sander-like devices, may be used to remove the top layer of the skin.
Laser therapy:
A narrow beam of light is used to kill the abnormal cells on the skin.
Photodynamic therapy:
Lasers, in combination with medicines that become active when exposed to light, are used to destroy abnormal cells.
With treatment, such as medicines and various therapies, actinic keratosis may be cured and further problems, such as cancer, may be prevented.
How can I take care of my skin?
The following are ways to take care of your skin:
Do not use tanning booths.
These can damage your skin as much as the sun.
Look for new bumps on your skin once a month.
Know what your regular birthmarks and unusual skin lesions look like. Watch closely for skin changes that appear on your skin, especially after 40 years of age.
Protect your skin from the sun's ultraviolet (UVA and UVB) rays.
Wear sunscreen that has an SPF (sun protectant factor) of 30 or higher. The sunscreen should also have UVA and UVB protection. Follow the directions on the label when using sunscreen. Put on more sunscreen if you are in the sun for more than an hour. Reapply sunscreen often if you go swimming or are sweating a lot.
Stay out of the sun between 11 AM and 2 PM. The sun is strongest and most damaging to your skin between these times.
Protect your lips by using lipsticks and lip balms that have sunscreen in them.
Wear long-sleeved shirts and pants to protect your arms and legs when you are out in the sun. Wear a hat with a wide brim to protect both your face and neck.
Where can I find support and information?
Your caregiver can help your family better understand how to support a person with actinic keratosis. Contact the following for more information:
American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
913-906-6000
1-800-274-2237
http://www.aafp.org
The Skin Cancer Foundation
245 5th Avenue, Suite 1403
New York, NY 10016
800-754-6490
www.skincancer.org
