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Actinic keratosis

An actinic keratosis (AK) is a scaly or crusty bump that arises on the surface of the skin. While the scale or crust may be horny, dry, and rough, often easier to feel than to see, the base may be light or dark, tan, pink, red, a combination of these colors, or the same color as the skin. Sometimes AK’s itch or can be tender to the touch.

AK’s are most likely to appear on exposed skin such as the face, ears, bald scalp, neck, backs of hands and forearms, and lips. They develop slowly and can become as large as a quarter of an inch. Once an AK occurs, it may disappear only to reappear later. AK’s rarely develop alone, and they are often seen several at a time.

What causes actinic keratosis and what is the danger?

  • Sun exposure is the cause of almost all AK’s. Sun damage to the skin accumulates over time, so an AK may be considered a negative dividend of a life spent in the sun
  • Actinic keratosis can be the first step in the development of skin cancer. It is considered a precursor of cancer or a pre-cancer
  • Up to 10 percent of active lesions (e.g.; those redder and more tender than the rest) will progress to squamous cell carcinomas (SCC)
  • SCC’s are usually not life threatening, provided they are detected and treated in the early stages. However, if this is not done, SCC’s can grow large and invade the surrounding tissues and, on rare occasions, metastasize or spread to the internal organs
  • The presence of AK’s is an indicator that sun damage has occurred and that any kind of skin cancer – not just SCC - can develop
Who is at greatest risk?
  • People who have fair skin, blonde or red hair, blue, green, or gray eyes are at the greatest risk. Because their skin has less protective pigment, they are the most susceptible to sunburn. Even those who are darker-skinned can develop keratoses if they expose themselves to the sun without protection
  • One in six people will develop an AK in their lifetime
  • Older people are more likely than younger ones to have AK’s, because cumulative sun exposure increases over time
  • Keratoses appear even in people in their early twenties who have spent too much time in the sun with little or no protection
Treatment of AK’s
There are several effective treatments for removing actinic keratoses. Not all keratoses need to be removed. The decision on whether and how to treat is based on the nature of the lesion, your age, and your health.

Remember, actinic keratosis is a warning signal of skin cancer. Heed that signal

Related Links
AAD AK Site

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