ACTINIC KERATOSES:  WHAT YOU SHOULD KNOW?

By Alan S. Peterson, MD

What are Actinic Keratoses?

Actinic Keratoses are rough, scaly patches on the skin. Many times they are red, but they don’t have to be. They are usually on areas of your body that get the most sun (for example, the head, neck, arms, and hands).

Who gets them?

People who have fair skin who live where it is sunny or work outside are most likely to get actinic keratoses. Batches are usually found on older people and are more common in men then in women. Those who got a lot of sun as a young person are also at risk. In our area, they are especially common in those who have been farmers or sun bathers. 

How is it treated?

It is important to treat actinic keratoses, otherwise they can turn into skin cancer (malignancy). 

Your doctor may remove the patches by freezing or scraping them or by having you put a prescription cream or gel on them. These can be expensive, but surgery after skin cancer develops is yet more expensive.

Your skin may be red, sore, or swollen after treatment. This should go away after 7-14 days. If you are using one of the creams or gels, the reddened areas may take longer than that to completely heal. 

How can I prevent Actinic Keratoses?

• Avoid spending a long time in the sun or using a tanning bed.
• Wear sunscreen when outside. Sunscreen should have a sun protection factor (or SPF) of 15 or higher. Make sure that the label says that it protects you from both UV-A and UV-B rays from the sun.
• Wear clothing that protects your skin from the sun (for example, a wide-brimmed hat, a shirt with long sleeves and long pants).

What happens if these are not treated?

Over a period of time, these pre-malignant areas of actinic keratoses can become malignant. It is easier to treat these when they are smaller and before they have become malignant. Those who have a tendency to develop actinic keratoses may continue to develop them even when they are not getting any further sunlight. The damage from the sun is cumulative, in other words, it adds up over time, even if one is no longer getting in the sun’s rays. 

Where can I get more information?

Many family physicians take care of these in their office. Dermatologists can also be a source of information and treatment. The American College of Dermatology has a website at http://www.skincarephysicians.com (click on ActinicKeratosesNet). The American Osteopathic College of Dermatology also has a website at http://www.aocd.org/skin/dermatologic_diseases (click on actinic keratoses).