Actinic keratosis (AK) is a spot on the top layer of skin that generally develops in adults and is pre-cancerous. Like many changes in the skin that occur over our lives, sunlight exposure and sun damage will cause these spots to appear. Over time, the photons of ultraviolet (UV) light trigger enough damage to the DNA of skin cells that the skin starts to grow more rapidly than it should.
In the case of actinic keratosis, what we typically see are red patches of skin that are scaly and rough. To some people, these rough scaly patches seem to be dry skin. But as opposed to dry skin which goes away with moisturizer, actinic keratosis may improve and be less scaly with moisturizing, but they never completely go away.
As soon as the moisturizer is discontinued, the rough skin builds up again. In some cases, there may be so much thickened skin over these spots, that a very thick mound of skin like a horn develops.
Sun-exposed areas of the face, lips, neck, shoulders, scalp, ears, forearms as well as on the back of hands is where actinic keratosis is most commonly found. Actinic cheilitis, another form of AK, appears on the lower lip.
Actinic Keratosis Causes
Because the spots are caused by long-term exposure to ultraviolet (UV) light, especially from sunlight and tanning beds, they most commonly occur in areas of skin that get the most sun. The face, neck, and scalp are the most common areas for actinic keratosis to develop.
Next, they may be seen on the backs of hands and fingers as well as the forearms and legs. Less commonly they can occur in other areas including the torso.
Some patients will have a solitary spot of actinic keratosis, whereas others may have dozens and dozens of spots. The fairer your skin and the more sun exposure you’ve had over time, the more spots you tend to see.
AKs also become more frequent with advancing age. Yet, they can start to develop and some people as young as the late 20s or early 30s
Actinic keratosis spots may eventually turn into full-blown skin cancer, called squamous cell carcinoma (SCC), or basal cell carcinoma. Most of the spots will never do this, however, it does occur with enough frequency that it is considered medically necessary to treat actinic keratoses to prevent the risk of developing skin cancer.
There is good news! Actinic keratosis spots are actually very easy to treat. The best dermatologists have extensive experience using liquid nitrogen to treat them.
Most commonly the liquid nitrogen is delivered directly to the treated area. The treatment is delivered in a pulse-like fashion using a liquid nitrogen dispensing gun known as a Cryac gun.
If extensive or very large, actinic keratoses may be treated with other options. One of the most frequent options is topical (applied) chemotherapy creams. 5-fluorouracil (Efudex, Carac) is the most frequently topical applied chemotherapy agent used.
Actinic keratosis treatment options include:
- Chemical peels
- Laser surgery
- Curettage and desiccation
- 5-fluorouracil (Carac®, Efudex®, Fluoroplex®)
- Diclofenac (Solaraze®)
- Hyaluronic acid
- Tirbanibulin (Klisyri®)
- Imiquimod (Aldara®, Zyclara®)
Photodynamic Therapy (PDT)
Photodynamic therapy is the most effective treatment option for widespread actinic keratosis located on the face and lips. During PDT, a light-sensitizing topical agent is applied, and the treated skin is then exposed to blue or red light to kill cancer cells. This one-and-done treatment option for actinic keratosis destroys lesions without harming healthy tissue.
Actinic Keratosis Treatment Omaha
In our clinics at Advanced Dermatology of the Midlands, we have experience prescribing this to thousands of patients every year. This treatment, and others like it, works by treating an entire field, so they can help treat spots that are visible. In some cases, this treatment may also bring out spots that are invisible.
It is important to protect your skin and reduce the risk of developing AKs and skin cancer. This includes practicing sun protection, such as wearing sunscreen, protective clothing, and hats, avoiding tanning beds, and seeking shade when the sun’s rays are strongest. Additionally, maintaining a healthy immune system can also contribute to overall skin health.
If you or someone you care about has spots in the skin that give you concern, consider scheduling a consultation with the best dermatologists in Omaha and Council Bluffs here. In people with actinic keratosis, it is not only important to treat the spots but also to examine and keep an eye on all of the skin in general because individuals who have these are at higher risk for developing skin cancer.
Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists
If you are interested in pursuing this wonderful skin treatment or want to find out more information, please contact us at (402) 933 3770. We offer this treatment in all our offices at 129th and Pacific (Sterling Ridge) and 15805 West Maple in Omaha and Valley View Drive in Council Bluffs. If you need more assistance, please consider seeing us in a consultation.