Actinic Keratosis
Actinic keratosis is a common skin condition resulting from years of sun exposure. Often appearing as rough patches on sun exposed areas, it serves as an early warning sign of skin damage. Recognizing and monitoring these changes is a crucial step in maintaining your long term skin health.
What are Actinic Keratoses (AKs)?
Actinic keratoses are precancerous growths on the skin caused by chronic UV exposure. They typically appear as rough, scaly patches on sun-damaged skin, such as the face, lips, ears, or hands. If left untreated, there is a chance these lesions can develop into squamous cell carcinoma, a form of skin cancer.
Due to Denver’s high altitude, which increases UV intensity by about 10% to 12% per 1,000 feet, Colorado residents are at a significantly higher risk for developing these precancerous lesions compared to people at sea level.
Professional Evaluation
Since Denver has a very arid climate, many residents mistake early actinic keratosis for chronic dry skin. If moisturizing does not resolve a rough patch within a few weeks, it is time for a professional evaluation.
Signs and Symptoms of Actinic Keratoses
The most common signs of actinic keratoses include:
-
Rough, dry, or scaly patch of skin that often feels like sandpaper.
-
Flat or slightly raised bumps on the top layer of the skin.
-
Color variations ranging from pink, red, or brown to flesh-toned.
-
Itching, burning, or bleeding in the affected area.
What Causes Actinic Keratoses?
The primary cause of actinic keratoses is cumulative damage from ultraviolet (UV) radiation from the sun or tanning beds. Over time, chronic UV exposure damages the DNA in skin cells, leading to abnormal cell growth and the formation of precancerous lesions on the skin’s surface.
These growths are found more frequently in people with fair skin, hair and eyes as well.
Does Denver’s Climate Increase the Risk of Actinic Keratoses?
Yes it can. Denver’s famous “300 days of sunshine” and high altitude are major risk factors. Because UV rays easily penetrate cloud cover and reflect off snow and other surfaces, daily sun protection is crucial for locals, even during the Colorado winter.
Actinic Keratoses Treatment Options
Left untreated, up to 10% of actinic keratoses can develop into squamous cell carcinoma. Treatment options include a variety of medical and advanced clinical procedures tailored to the patient’s skin type and lesion severity. Standard medical treatments are highly effective at removing abnormal cells. They include:
Cryotherapy
Freezing the lesion with liquid nitrogen to destroy the precancerous cells. Cryotherapy is a great option for spot treatment. If you have more numerous AKs, you may require a field treatment (something that will treat an entire area of skin).
Topical Chemotherapy Creams
Prescription topical treatments, like 5-fluorouracil (Efudex) and imiquimod (Aldara) are examples of creams that may be prescribed to treat an area of skin such as the face or chest. These creams are applied at home to target damaged cells.
Curettage
Curettage is a minor surgical procedure where a dermatologist uses a sharp, loop-shaped instrument (called a curette) to scrape away thick or stubborn precancerous cells. This method physically removes the actinic keratosis lesion, allowing healthy new skin to regenerate in its place.
Photodynamic Therapy (PDT)
A specialized treatment using a light-activated medication (like Levulan or Ameluz) combined with BLU-U light to target and destroy precancerous cells.
Advanced AK Treatments at Core Dermatology
At Core Dermatology, we offer advanced treatments for widespread or stubborn lesions:
- Specialized Photodynamic Therapy (PDT): At Core Dermatology we offer red light therapy which is a type of photodynamic therapy. During red light therapy, the photosensitizing agent Ameluz (aminolevulinic acid hydrochloride) 10% gel is applied to the skin. After an incubation period, during which the gel is allowed to sit on the skin for a given period of time, a red light is used to activate the Ameluz. The end result is clearance of precancerous cells. Most patients experience clearance of the majority of their AKs. A second treatment may be needed if AKs remain.
- Advanced Laser Resurfacing: Using fractional (Fraxel) or CO2 lasers to remove the top layer of damaged skin and stimulate the growth of healthy new skin.
The board-certified dermatologists at Core Dermatology specialize in these minimally invasive treatments that clear precancerous cells with minimal downtime, allowing patients to get back to their active Colorado lifestyles quickly.
Frequently Asked Questions (FAQ) About Actinic Keratosis
Are actinic keratoses skin cancer?
No, but they are precancerous. Actinic keratoses are not skin cancer, but they are considered the earliest stage of a squamous cell carcinoma. If left untreated, the damaged cells can mutate into malignant skin cancer over time.
Can actinic keratoses go away on their own?
While some actinic keratoses may disappear temporarily, they almost always return upon further sun exposure. Spontaneous regression is rare. Because the underlying DNA damage remains, professional medical treatment is required to completely remove the precancerous cells.
How do you treat actinic keratoses on the scalp?
Treating actinic keratoses on the scalp is critical, especially for individuals with thinning hair. Standard treatments include:
- Liquid nitrogen (cryotherapy) for individual spots.
- Topical chemotherapy creams for broader areas.
- PDT light therapy for treating the entire scalp efficiently.