Actinic Keratosis (AK) : Causes, Symptoms and Treatment

Overview

Actinic keratosis (AK) is a scaly rough, patch on the skin which develops from years of sun exposure. If left untreated, the risk of actinic keratoses turning into a type of skin cancer, known as squamous cell carcinoma is about 5% to 10%.

The best way for people to prevent AK is to protect themselves from sun damage. When they notice new red or rough bumps on their skin, they must consult a doctor for diagnosis and treatment.

This blog is a comprehensive guide to actinic keratosis (AK), its causes, symptoms, prevention, and treatment.

What is Actinic Keratosis?

Actinic keratosis, also called solar keratosis, is a skin disorder that leads to rough and scaly skin patches. AK is a type of precancerous condition, meaning that if people do not get timely treatment for this condition, it could lead to cancer.

What are the symptoms of Actinic Keratosis?

Typically, the first symptom of actinic keratosis are rough, raised bumps on the skin that may vary in colour but often have a brown or yellow crust on top. These bumps can be grey, pink, red, or the same colour as the skin. The symptoms can also include the following:

●       Bleeding

●       Dry, scaly lips

●       Burning, stinging, or itching

●       Loss of colour in the lips

●       Pain or tenderness

When should you call the doctor?

It can be not easy to distinguish between noncancerous spots and cancerous ones. Therefore, it is best to evaluate any new skin changes by the doctor, mainly when a patch or scaly spot persists, grows, or bleeds.

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What are the causes of Actinic Keratosis?

The most common cause of actinic keratosis is frequent or intense exposure to ultraviolet (UV) light from sun or indoor tanning equipment like tanning beds. UV light can damage the outer layer of skin cells called keratinocytes.

 What are the risk factors for Actinic Keratosis?

Although anyone can develop actinic keratosis, a person is at increased risk if they have: 

• Red or blond hair
• Blue or light-coloured eyes
• A weakened immune system
• A history of a lot of multiple or severe sunburns

A person can also get actinic keratosis if they 

• Are older than the age of 40
• Live in a sunny place
• Work outdoors

What are the complications of Actinic Keratosis?

When treated early, actinic keratosis can be cleared up or removed. However, when left untreated, some of these spots may progress to squamous cell carcinoma, a type of cancer that is not typically life-threatening when detected and treated early.

How is Actinic Keratosis treated?

The treatment option for a patient suffering from actinic keratosis depends on the number of AKs and their appearance. During an appointment, the doctor can suggest removing the skin patches. The doctor may use the following methods to treat actinic keratosis:

1. Chemical peels – they are similar to a medical-grade face mask. The doctor applies the peel during an appointment visit. The chemicals in the treatment safely eliminate unwanted patches in the top layer of skin. The treated region will be sore and red for the first few days. As the skin heals, the patient can notice a new, healthy layer of skin.
2. Cryotherapy – when people have one or two AKs, the doctor may use cryotherapy. During this procedure, the doctor may use a cold substance like liquid nitrogen to freeze skin growths. After the treatment, these growths will blister and peel off within a few days.
3. Excision – during this procedure, the doctor may first numb the skin around the AK. Afterwards, the doctor cuts out or scrapes away the AKs and stitches the area back together. Typically, it takes two to three weeks for the wound to heal.
4. Photodynamic therapy – when people have multiple AKs or AKs that return after treatment, the doctor may suggest photodynamic therapy. During this procedure, creams and particular light therapy destroy precancerous skin cells. Patients must stay out of sun for some days while the treated skin is healing.
5. Surgery and biopsy – the doctor may surgically remove the lesion for examination to determine if the AK is cancerous.
6. If you have numerious actinic keratoses, your treating doctor may prescribe a medicated cream gel or cream to remove them, such as fluorouracil, imiquimod , ingenol mebutate or diclofenac . These products may lead to redness, scaling or a burning sensation for a few weeks.
7. Dermabrasion – As the name suggests, the doctor uses a handheld tool to sand the skin to improve its appearance. Patients of AK must be ready to tolerate the pain and the red and raw skin. The treatment is recommended for patients with large lesions that cannot be treated with topical medications.
8. Microtubule inhibitors – are used to stabilize damaged skin and clear skin lesions. Treatment areas are the face and scalp, and doctors must care to avoid the eyes.

How can people prevent Actinic Keratosis?

Avoiding prolonged UV exposure is the best way for prevention of actinic keratosis. People can also protect their skin by doing the following: 

Applying sunscreen every day, even during winters or in cloudy weather, and reapplying at least every two hours.

• Avoiding sun exposure between 10 am and 2 pm, when UV light is the most intense.
• Keeping away from sunlamps, tanning salons, and tanning beds.
• Wearing sun-safe clothing like long-sleeved shirts, long pants, and hats.
• Regularly checking skin for lesions and reporting the same to the doctor.

Conclusion

Actinic keratosis is a  skin disorder that needs immediate treatment. Most AKs disappear with surgical or topical treatment. People can lower their risk of actinic keratosis by protecting their skin from sun exposure and ultraviolet light. They should see the doctor as soon as they may be experiencing symptoms because the sooner they seek treatment for actinic keratosis, the less likely they are to develop skin cancer.

Frequently Asked Questions 

1. How is actinic keratosis diagnosed?

The dermatologist (doctor specialising in skin conditions) or other doctors can often diagnose actinic keratosis by carefully examining the skin and using magnification. When the doctor is uncertain or if the skin looks unusual, they can suggest a skin biopsy, a short, minimally invasive procedure that allows the skin cells to be diagnosed under a microscope to obtain a specific diagnosis.

2. How long does it take for actinic keratosis to go away?

Depending on size and number of actinic keratoses, it might take up to 3 months for actinic keratoses to disappear after the completion of the treatment.

 3. Does actinic keratosis return after the treatment?

 Actinic keratosis can sometimes return if people do not prevent further sun damage. During and after the treatment, they must limit their exposure to UV light.