Actinic Keratosis

Actinic keratosis (AK) is one of the most common skin conditions that prompts patients to seek care of their dermatologists.  It is a type of skin damage caused by excessive UV light from sun, and presents as rough and scaly raised growth on skin, especially on the head and neck, but can occur anywhere one has had a lot of sun exposure. On lips, AKS present as white scaly patches, associated with occasional itching or burning sensation, but other than a textural change, most AKs are asymptomatic. It is important to get these treated as untreated AKs can develop into squamous cell cancer, a type of skin cancer.

Causes of Actinic Keratosis

As is the case with skin cancers, certain populations are at greater risk of developing AKs.  Having fair complexion with blue eyes, tendency to get freckles, having occupations involving outdoor work, medications or genetic conditions that weaken the immune system or place individuals at higher risk for skin damage from solar UV rays, all increase your risk for AK and hence for skin cancer.​

Treatment of Actinic Keratosis

Most AKs are very easily diagnosed clinically and can be treated via multiple effective and affordable modalities. The treatment is aimed at preventing progression of AK into skin cancer, and generally falls into two categories: spot treatment vs field treatment. Regardless of the treatment used, it is extremely important to use sunscreen regularly and take care of your healing skin after treatment until the damaged skin is replaced by newer, healthier skin. A freshly treated skin is especially sensitive to sun and negligence can cause excessive pain, blistering or even bleeding.

  • Cryotherapy – very cold liquid nitrogen is used to cause a freeze-burn to focused area on skin. The treated spots undergo blistering reaction.  The blisters are eventually replaced by new healthier skin, hopefully without the damage.  

  • Chemical peel – When damage is diffuse, the spot treatment, although very effective against individual spots, may not work. Chemical peels offer field treatments when the damage is over a larger area.  The chemicals applied on skin cause superficial damage to treated skin and help slough the top layer, and hence the damage. 

  • Photodynamic therapy (PDT) – A medication is applied to an areas of diffuse damage, that makes precancerous cells preferably sensitive to blue light, which is then applied in a controlled setting, to kill the cancer cells.

  • Laser resurfacing – Lasers can target the top damaged layer and help body replace with new, healthier skin. 

  • Topical Medications – Prescriptions anti-cancer medications and immuno-modulators can be prescribed for use on defined area for defined periods of time, usually several times a week for several weeks, to help replace the damaged skin.