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Actinic keratosis
Solar keratosis; Sun-induced skin changes - keratosis; Keratosis - actinic (solar); Skin lesion - actinic keratosis
Actinic keratosis is a small, rough, raised area on your skin. Often this area has been exposed to the sun for a long period of time.
Some actinic keratoses may develop into a type of skin cancer.
Causes
Actinic keratosis is caused by exposure to sunlight.
You are more likely to develop it if you:
- Have fair skin, blue or green eyes, or blond or red hair
- Had a kidney or other organ transplant
- Take medicines that suppress the immune system
- Spend a lot of time each day in the sun (for example, if you work outdoors)
- Had many severe sunburns early in life
- Are older
Symptoms
Actinic keratosis is usually found on the face, scalp, back of the hands, chest, or places that are often in the sun.
- The skin changes begin as flat and scaly areas. They often have a white or yellow crusty scale on top.
- The growths may be gray, pink, red, or the same color as your skin. Later they may become hard and wart-like or gritty and rough.
- The affected areas may be easier to feel than see.
Exams and Tests
Your health care provider will look at your skin to diagnose this condition. A skin biopsy may be done to see if it is cancer.
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
Treatment
Some actinic keratoses become squamous cell skin cancer . Have your provider look at all skin growths as soon as you find them. Your provider will tell you how to treat them.
Squamous cell skin cancer
Squamous cell cancer is the second most common type of cancer in the United States. Other common types of skin cancer are:Basal cellMelanoma
Growths may be removed by:
- Burning (electrical cautery)
- Scraping away the lesion and using electricity to kill any remaining cells (called curettage and electrodesiccation)
- Cutting the tumor out and using stitches to place the skin back together (called excision)
- Freezing (cryotherapy, which freezes and kills the cells)
If you have many of these skin growths, your doctor may recommend:
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A laser treatment called
photodynamic therapy
Photodynamic therapy
Phototherapy; Photochemotherapy; Photoradiation therapy; Cancer of the esophagus-photodynamic; Esophageal cancer-photodynamic; Lung cancer-photodynam...
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- Skin creams, such as 5-fluorouracil (5-FU) and imiquimod
Outlook (Prognosis)
A small number of these skin growths turn into a type of skin cancer called squamous cell carcinoma.
When to Contact a Medical Professional
Call your provider if you see or feel a rough or scaly spot on your skin, or if you notice any other skin changes.
Prevention
The best way to lower your risk for actinic keratosis and skin cancer is to learn how to protect your skin from sun and ultraviolet (UV) light .
Learn how to protect your skin from sun...
Addison disease is a disorder that occurs when the adrenal glands do not produce enough hormones.
Things you can do to lower your exposure to sunlight include:
- Wear clothing such as hats, long-sleeved shirts, long skirts, or pants.
- Try to avoid being in the sun during midday, when ultraviolet light is most intense.
- Use high-quality sunscreens, preferably with a sun protection factor (SPF) rating of at least 15. Pick a broad spectrum sunscreen that blocks both UVA and UVB light.
- Apply sunscreen before going out into the sun, and reapply often -- at least every 2 hours while in the sun.
- Use sunscreen year-round, including in the winter.
- Avoid sun lamps, tanning beds, and tanning salons.
Other things to know about sun exposure :
Sun exposure
Many skin changes, such as skin cancer, wrinkles, and age spots are caused by exposure to the sun. The two types of sun rays that can injure the skin...
- Sun exposure is stronger in or near surfaces that reflect light, such as water, sand, concrete, and areas painted white.
- Sunlight is more intense at the beginning of the summer.
- Skin burns faster at higher altitudes.
References
Habif TP. Premalignant and malignant nonmelanoma skin tumors. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 21.
Ibrahim SF, Brown MD. Actinic keratoses. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 5.
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Actinic keratosis on the arm - illustration
For people with actinic keratosis, cumulative skin damage is caused by repeated exposure to all ultraviolet light, including that found in sunshine. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions. The lesions, like those seen here on the arm, may later become cancerous.
Actinic keratosis on the arm
illustration
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Actinic keratosis - close-up - illustration
Actinic keratosis is associated with cumulative skin damage, caused by repeated exposure to the ultraviolet light found in sunshine. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions similar to the ones in this photograph. The lesions may later become cancerous (pre-cancerous).
Actinic keratosis - close-up
illustration
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Actinic keratosis on the forearms - illustration
Cumulative skin damage is caused by repeated exposure to the ultraviolet light found in sunshine. Areas with high exposure such as the forearms, face, back of the neck, and scalp (bald individuals) are common sites. Over the years, the genetic material of cells becomes irreparably damaged and may produce lesions like these on the forearms. The lesions, called actinic keratosis, may later become cancerous.
Actinic keratosis on the forearms
illustration
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Actinic keratosis on the scalp - illustration
Cumulative skin damage is caused by repeated exposure to the ultraviolet light found in sunshine. Areas with high exposure such as the scalp (bald individuals), forearms, face, and back of the neck are common sites. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions like these on the scalp. The lesions, called actinic keratosis, may later become cancerous.
Actinic keratosis on the scalp
illustration
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Actinic keratosis - ear - illustration
These pre-malignant lesions (brown) are actinic keratoses. They are scaly and rough, and there is evidence of bleeding. They are shown here on a typical, sun-exposed area of skin.
Actinic keratosis - ear
illustration
-
Actinic keratosis on the arm - illustration
For people with actinic keratosis, cumulative skin damage is caused by repeated exposure to all ultraviolet light, including that found in sunshine. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions. The lesions, like those seen here on the arm, may later become cancerous.
Actinic keratosis on the arm
illustration
-
Actinic keratosis - close-up - illustration
Actinic keratosis is associated with cumulative skin damage, caused by repeated exposure to the ultraviolet light found in sunshine. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions similar to the ones in this photograph. The lesions may later become cancerous (pre-cancerous).
Actinic keratosis - close-up
illustration
-
Actinic keratosis on the forearms - illustration
Cumulative skin damage is caused by repeated exposure to the ultraviolet light found in sunshine. Areas with high exposure such as the forearms, face, back of the neck, and scalp (bald individuals) are common sites. Over the years, the genetic material of cells becomes irreparably damaged and may produce lesions like these on the forearms. The lesions, called actinic keratosis, may later become cancerous.
Actinic keratosis on the forearms
illustration
-
Actinic keratosis on the scalp - illustration
Cumulative skin damage is caused by repeated exposure to the ultraviolet light found in sunshine. Areas with high exposure such as the scalp (bald individuals), forearms, face, and back of the neck are common sites. Over the years, the genetic material of cells becomes irreparably damaged and produces lesions like these on the scalp. The lesions, called actinic keratosis, may later become cancerous.
Actinic keratosis on the scalp
illustration
-
Actinic keratosis - ear - illustration
These pre-malignant lesions (brown) are actinic keratoses. They are scaly and rough, and there is evidence of bleeding. They are shown here on a typical, sun-exposed area of skin.
Actinic keratosis - ear
illustration
-
Melanoma and other skin cancers
(In-Depth)
Review Date: 8/20/2016
Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
