Actinic Keratosis (AK), also known as solar keratosis, is a skin condition that serves as a warning sign of the early stages of skin cancer. Typically manifesting as rough, scaly patches on the skin, AKs are caused by long-term exposure to ultraviolet (UV) radiation from the sun or artificial sources such as tanning beds. These lesions commonly appear on areas most exposed to the sun, including the face, lips, ears, back of the hands, forearms, scalp, and neck. Understanding and managing actinic keratosis is crucial because, if left untreated, it can progress to squamous cell carcinoma (SCC), a type of skin cancer. This blog delves into the identification, prevention, and treatment of actinic keratosis, highlighting the importance of proactive skin care and sun protection.

Identification and Symptoms

Actinic keratosis lesions vary in appearance. They may be small and rough, resembling sandpaper, or they might appear as larger, scaly, crusty growths. The colour of these patches can range from skin-toned to red, brown, or pink. They may be itchy or tender, especially when touched, and sometimes they disappear only to reappear later. Early detection of AK is key to preventing the development of SCC.

Risk Factors

Factors that increase the risk of developing actinic keratosis include having fair skin, blue or green eyes, and red or blond hair; a history of extensive sun exposure; older age; a history of sunburns; and a weakened immune system. People who have spent a lot of time outdoors for work or leisure without adequate sun protection are particularly at risk.

Prevention

The best way to prevent actinic keratosis is to protect your skin from the sun. This includes seeking shade during peak sun hours (10 AM to 4 PM), wearing sun-protective clothing (such as hats and long sleeves), applying broad-spectrum sunscreen with an SPF of 30 or higher every day, and avoiding tanning beds. Regular skin checks are also essential for identifying any new or changing lesions early.

Treatment Options

Treatment for actinic keratosis varies depending on the number, size, and location of the lesions. Options include:

Topical Treatments: Medications such as 5-fluorouracil and imiquimod cream can be applied to the lesions, causing them to peel away.

Cryotherapy: The most common treatment, which involves freezing the lesions with liquid nitrogen, causing them to scab and fall off.

Photodynamic Therapy (PDT): A two-step process that involves applying a photosensitizing agent to the skin, followed by exposure to a light source that activates the agent, destroying the abnormal cells.

Curettage and Electrosurgery: Scraping away the lesion and using electricity to burn the base and edges of the treated area.

The Role of Regular Skin Checks

Because actinic keratosis is a precursor to squamous cell carcinoma, regular skin checks by a dermatologist are crucial. These checks can help catch AKs and other skin abnormalities early, significantly reducing the risk of progression to skin cancer. Individuals with a history of AKs may require more frequent examinations.

Conclusion

Actinic keratosis is a clear signal from our skin that past sun damage may lead to skin cancer if not addressed. By recognizing the early signs of AK, taking preventative measures against sun damage, and seeking appropriate treatment, individuals can significantly reduce their risk of developing skin cancer. Always consult with a dermatologist or healthcare provider to determine the best course of action for any skin concerns. Prioritising skin health and sun protection is essential for preventing actinic keratosis and maintaining healthy skin throughout life.