You go to the dermatologist with some concerning spot, and you’re told that you have Actinic Keratosis (AK) or Actinic Keratoses (plural).
The good news is…you don’t have skin cancer. . . yet.
Approximately 58 million Americans have at least one AK, so you are not alone. Actinic keratosis is a common precancer on the skin, generally due to chronic exposure to UV rays. You may have heard this referred to as solar keratosis, precancerous spots, or premalignant spots. Because AKs arise from long-term UV exposure, if you have one AK, you will likely develop more in the future. It also means you will need to see your dermatologist often to have your skin evaluated.
Why do I need to have AKs treated?
AKs are both an indication someone has had significant UV exposure and a precursor to a potential skin cancer. AKs can potentially develop into squamous cell carcinoma (SCC), the second most common form of skin cancer. If left untreated, SCCs can become invasive and spread. SCCs general grow slowly, but they can become life threatening if not treated.
Only about 10% of AKs will develop into a skin cancer. However, most SCCs begin as AKs. Because there is no way to predict which AKs will develop into skin cancer, we recommend treating all AKs.
What do they look like?
AKs typically appear in areas of the body with sun exposure. The scalp, face, lips, ears, and hands are common areas.
AKs can vary in appearance and size. They can be scaly patches, a dry spot, or small bumps. The colors vary from red, pink, and brown. If you see new spots that are developing or spots that won’t heal, then see your dermatologist to have them evaluated.
What are the treatment options?
The most common treatment we use for AKs is cryosurgery. This process entails spraying liquid nitrogen on the AK to freeze the spots. Most patients will develop redness afterward, while some patients may react less to treatment. This treatment is quick and can be performed in the office.
We may use topical treatments, especially for larger areas with multiple AKs. Combination treatments are also common, depending on the areas affected, size and number of AKs.
How do I prevent AKs?
The tips for preventing Actinic Keratosis are the same as the tips for prevention of skin cancer:
- Limit your UV exposure. Don’t use tanning beds and avoid the sun during peak hours of 10AM to 2PM. Both sunburns and accumulated sun exposure over time can cause AKs and skin cancer.
- Use sunscreen daily. Use a broad-spectrum sunscreen with SPF of at least 30. Make it a daily habit to put on your sunscreen each morning to all exposed areas.
- Cover up. If you must be outdoors, covering up is the best protection. Wear a hat and clothing that has UV properties to protect your skin.
It can be difficult to determine whether a spot is benign, precancerous, or a skin cancer. Thus, if you see any new spot or lesion, then schedule an appointment with your dermatologist. If you’ve had an AK in the past, then see your dermatologist annually for a total body skin exam.
Vinh Chung, MD is a board certified dermatologist and a fellowship trained Mohs surgeon. He specializes in the diagnosis and treatment of skin cancer at Vanguard Skin Specialists. Dr. Chung sees patients in Colorado Springs, Canon City, Pueblo, and Woodland Park.