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Actinic keratosis on the arm
Actinic keratosis on the arm


Actinic keratosis - close-up
Actinic keratosis - close-up


Actinic keratosis on the forearms
Actinic keratosis on the forearms


Actinic keratosis on the scalp
Actinic keratosis on the scalp


Actinic keratosis - ear
Actinic keratosis - ear


Definition:

Actinic keratosis is a precancerous growth on the skin.



Alternative Names:

Solar keratosis; Sun-induced skin changes - keratosis; Keratosis - actinic (solar)



Causes, incidence, and risk factors:

Actinic keratosis is caused by sun exposure. It occurs most commonly in fair skin, especially in the elderly and in young people who have light skin.



Symptoms:
  • Rough and dry skin lesion
  • Patch or growth on the skin
    • Limited to one area (localized)
    • Located on the face, scalp, back of the hands, chest, or other sun-exposed areas
    • Gray, pink, red (erythematous), or the same color as the skin
    • Begins as flat and scaly areas
    • Later develops a hard and wart-like or gritty, rough, and "sandpapery" surface -- may develop a horn-like texture

The skin lesion may be easier to feel than to see.



Signs and tests:

The health care provider makes the diagnosis based on the appearance of the skin growth. A skin biopsy may reveal any cancerous changes, if they occur.



Treatment:

Because actinic keratoses are precancerous changes, have them examined promptly. Follow your health care provider's advice for treatment.

Growths may be removed by:

  • Burning (electrical cautery)
  • Freezing (cryotherapy )
  • Surgery

Growths may also be treated with medications that cause the skin to peel or come off. More recently, lasers and other light sources have been used to treat actinic keratoses.

Creams such as 5-fluorouracil and imiquimod are used for people who have many lesions. These creams usually cause irritation and redness.



Support Groups:



Expectations (prognosis):

Actinic keratosis itself is benign , but it may develop into skin cancer . If left untreated, approximately 1% of actinic keratoses develop into squamous cell carcinoma .

Removal of the growth is usually effective.



Complications:
  • Squamous cell carcinoma
  • Irritation and discomfort of the skin growth


Calling your health care provider:

Call for an appointment with your health care provider if areas of persistent roughness or scaliness develop in sun-exposed skin.



Prevention:

Ways to prevent actinic keratosis:

  • Reduce sun exposure and protect your skin from the sun.
  • Wear protective clothing such as hats, long-sleeved shirts, long skirts, or pants.
  • Try to avoid sun exposure during midday, when ultraviolet light is most intense.
  • Use high-quality sunscreens, preferably with SPF (sun protection factor) ratings of at least 15. Pick a sunscreen that blocks both UBA and UVB light.
  • Apply sunscreen at least 30 minutes before going out into the sun, and reapply frequently.
  • Use sunscreen year-round, including in the winter.


References:

de Berker D, McGregor JM, Hughes BR. Guidelines for the management of actinic keratoses. Br J Dermatol. 2007;156:222-230.




Review Date: 10/11/2008
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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