Actinic Keratosis: Symptoms, Causes & Treatment

Actinic keratosis is also known as solar keratosis. It is a warning sign of ultraviolet radiation damage to the skin. Unless it is treated early, the skin condition has the potential to turn cancerous. Lesions can appear on people as young as 20 years old. However, actinic keratosis is more common in those over the age of 40. People who work outside, live in warmer climates or engage in outdoor sports and activities are more likely to develop actinic keratosis.

Sun damage is cumulative. The damage accumulates and changes the DNA of skin cells. After age 18, the damage increases by 10 percent every decade. Sunscreen should be your best friend. In 2012, there were 5.4 million cases of non-melanoma skin cancer in the United States. Between 1994 and 2004, diagnosis and treatment increased by 77 percent. This shows how actinic keratosis poses a significant threat to public health and it is the most common precancer.

What is Actinic Keratosis?

Actinic keratosis is a condition that causes scaly, rough lesions on the skin. It’s caused by exposure to ultraviolet rays from the sun. Tanning or sun exposure without adequate UV protection increases the risk of developing actinic keratosis. The majority of cases are benign. However, they indicate sustained sun damage and may develop into skin cancer.

If someone develops an actinic keratosis patch, they face the risk of developing more of them. One patch usually multiplies into more growths over a period of time. A dermatologist always refers to the condition in its plural form—actinic keratoses—even if the patient only has one lesion.

Actinic Keratosis is Precancerous

Actinic keratosis is a precancerous condition and without treatment, it may progress into a type of non-melanoma skin cancer called squamous cell carcinoma. The lesion has a red, scaly, crusted surface and may have chronic sores and a raised, wart-like appearance on the skin. It may stay isolated in one area or it may spread to nearby skin and lymph nodes. Squamous cell carcinoma can be aggressive and fatal. Fortunately, most forms of actinic keratoses are benign. If doctors identify signs of actinic keratosis early, they can treat it.

Risk Factors for Actinic Keratosis

Prolonged Sun Exposure

Prolonged exposure to the sun’s ultraviolet rays is the primary cause of actinic keratosis. Harmful rays cause damage that accumulates over time. At a young age, the body can heal the skin after UV damage. However, age impacts the body’s ability to heal itself. Therefore, actinic keratosis is more common in people over the age of 40.

Tanning Beds and Sun Lamps

Exposure to artificial ultraviolet radiation from tanning beds and sun lamps also cause actinic keratosis, as well as premature skin aging and skin cancer. Artificial ultraviolet rays discharge a more concentrated form of UV radiation. Long-term exposure to X-rays and industrial agents also contribute to actinic keratoses.

People who spend extended periods of time outdoors under the sun face a higher risk of developing actinic keratoses. Other high-risk groups include:

• Individuals with fair skin
• People with naturally blonde or red hair or light-colored eyes (blue, green and gray)
• Those with weakened immune systems (AIDS and HPV patients, cancer patients, organ-transplant recipients)
• People with extra sensitive skin
• Individuals with a long history of sunburns
• People who live close to the equator

Symptoms of Actinic Keratosis

Areas that get the most sun exposure are the most vulnerable to actinic keratosis—the face, scalp and back of the hands or arms. Actinic cheilitis is an aggressive variant of actinic keratosis that looks white and often appears on the lower lip. Most cases do not cause symptoms, just changes to the skin. Actinic keratoses are easier to identify by touch than by sight. Signs to look out for include:

• Rough patches on the skin
• Sandpaper-like patches on the skin that are painful to the touch
• Dry or chapped lips
• Burning and itching

The patches may vary in color. They may be reddish-brown, yellowish tan, pink, red or skin-colored. Actinic keratoses appear, vanish after a while and then reappear again. The lesion is more likely to reappear if the patient ventures outside without proper sun protection. Even if the actinic keratosis disappears on its own, consult a dermatologist to get an accurate diagnosis because the damage can continue to grow.

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Diagnosing Actinic Keratosis

First, the dermatologist examines the skin and if they find a growth they suspect may be actinic keratosis, they will perform a biopsy. In the procedure, the doctor removes a small portion of the growth and sends it to a lab for testing.

Treating Actinic Keratosis

Actinic keratoses is treatable if it is detected and diagnosed early. Treatment options vary widely and depend on how many lesions the patient has, their age and their overall health. The doctor may recommend a surgical procedure, topical treatment or photodynamic therapy. In some cases, patients may need a combination therapy with more than one treatment. After treatment, the skin may be more sensitive to sunlight.

Surgical Procedures

In surgery, the doctor cuts off the lesion from the skin. There are four common surgeries: cryosurgery, curettage, chemical peels and laser surgery.

Cryosurgery

This procedure freezes off the legion with liquid nitrogen, which causes it to turn red and erupt. Eventually, the skin will crust and fall off, taking the actinic keratosis with it. This procedure is common because it is quick and safe.

Curettage

This procedure involves scraping or shaving off parts of the lesion with a special surgical instrument. After the lesion comes off, the doctor uses heat or a chemical agent to kill off any remaining actinic keratosis cells.

Laser Surgery

In a laser surgery, doctors can vaporize affected skin tissue with a strong, medical-grade laser that emits high-intensity light.

Chemical Peel

A chemical peel removes the top layers of skin. The skin will be sore and inflamed, but in a few weeks it will grow back in new, healthy layers.

Topical Treatments

Doctors recommend topical treatments when the patient has more than one actinic keratoses because surgical treatment may not be effective. Doctors may prescribe a cream, solution, chemical peel or gel to apply on the lesions.

The topical treatment helps directly remove the affected tissue. Common treatments a doctor may prescribe include 5-fluorouracil, imiquimod, ingenol mebutate and diclofenac.

Photodynamic Therapy

Photodynamic therapy is an effective way to treat widespread actinic keratosis lesions on the scalp and face. During the treatment, doctors apply a light-sensitive chemical agent to the affected area. A strong light source activates the chemical and then the chemical agent destroys the actinic keratoses. Doctors only need to perform this treatment once and it gets rid of lesions without damaging healthy tissue.

Preventing Actinic Keratosis

By taking basic precautions, you can avoid sun damage and actinic keratosis:

Use Sunscreen

Don’t go outside during the day without a sunscreen that offers broad spectrum UVA/UVB SPF protection of at least 30. It helps protect your skin from the sun’s damaging UV rays. Use a lip balm with SPF protection too because the lips are also at risk for sun damage.

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Wear Protective Clothing

Along with sunscreen, wear clothing that covers your skin—long-sleeved shirts, full-length trousers and a wide-brimmed hat to shield your face from the sun.

Avoid Tanning Salons

Lamps in tanning salons accelerate “photoaging,” a type of premature aging from UV radiation. Tanning lamps can be even stronger than the sun’s rays.

Avoid the Midday Sun

Finally, try to limit the time you spend outside between 10 a.m. until 2 p.m. when the sun’s rays are strongest.

Supplements for Healthy Skin

Vitamin C

With antioxidant properties, vitamin C offers protection against UVA and UVB rays from the sun. Fresh fruits and vegetables contain vitamin C, but supplements are a good way to take advantage of its health benefits as well. The suggested serving size is 1,000 mg every day.

Vitamin A

Frequently used in cosmetics, vitamin A helps protects the skin from sun damage and may improve skin health. It comes from beta-carotene, which is present in carrots, pumpkins, mangoes, sweet potatoes and papayas. As a dietary supplement, take 30 mg of Vitamin A powder a day.

Vitamin E

Research suggests that vitamin E supplements and topical gels and creams may help protect the skin against sun damage and promote skin elasticity. It also acts as an antioxidant to reduce free radicals. Take Vitamin E powder in a daily serving size of 500 mg to 1,000 mg with meals.

Aloe Vera Extract

Aloesin is an active compound in aloe vera, which may help treat sunburns, hyperpigmentation — including sun spots — and skin conditions like psoriasis. Take 1,000 mg of aloe vera extract powder once a day with water as a dietary supplement.

Green Tea Extract

Green tea extract has antioxidant properties that may help reduce inflammation, repair skin pigmentation and treat skin conditions like acne and rosacea. It may also improve signs of aging, often a result of sun damage. As a dietary supplement, take 500 mg once or twice a day for no longer than three months, to avoid liver or kidney damage from excess intake.

The Bottom Line

Actinic keratosis a skin condition caused by sun damage. People who spend a lot of time outdoors for work or other activities are more likely to suffer skin damage from the sun. Physical characteristics, such as fair skin, blond or red hair and light-colored eyes also increase the risk. The light from tanning beds can also cause damage to the skin.

Actinic keratosis is precancerous and without treatment, it can lead to skin cancer. But with early diagnosis, it is treatable with surgery, topical treatments or photodynamic therapy. To prevent actinic keratosis from appearing in the first place, always wear sunscreen, limit sun exposure during midday, wear protective clothing and avoid tanning salons. Supplements can also promote healthy skin that may be less susceptible to damage. However, they are not a substitute for medical treatment. Always consult a doctor before using supplements.

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Created on Mar 13th 2020 15:51. Viewed 287 times.

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