Actinic keratosis (AK), also known as solar keratosis, is a scaly or crusty lesion that usually occurs on the scalp, face, ears, lips, shoulders, neck, and on the back of the hands and forearms — areas that are most often exposed to the sun. Lesions range in color from skin-colored to reddish brown. These lesions are not cancerous but are considered precancerous. If you have one, you probably will develop more, according to the Skin Cancer Foundation.
People who are fair skinned with blue eyes are most at risk of developing AKs, and the risk increases with age. Most of the time, there are no symptoms, other than the lesion itself; however, according to the American Academy of Family Physicians (AAFP), some might cause a mild burning sensation.
Does actinic keratosis need to be treated?
The vast majority of AK lesions are and remain benign, according to the Skin Cancer Foundation. However, the presence of these lesions indicates that you have sustained skin damage and that you are at risk of developing skin cancer. They are treated not for their presence, but because of their potential to become cancer. Most AKs, when they do become cancerous, evolve into squamous cell carcinoma.
The more lesions have that are left untreated, the greater chance of developing skin cancer. Different studies cite varying risks of an AK evolving into cancer, according to the AAFP. It can range anywhere from .24 percent for each year you have the AK to 6 to 10 percent over 10 years. The American Academy of Dermatology (AAD) recommends that people with multiple AKs be under a dermatologist's care, not only for treatment of the lesion but also for prompt treatment should a lesion develop into skin cancer.
What are treatment options?
There are a number of different treatment options for actinic keratosis. Your doctor will help you decide which one is best for you.
Cryosurgery: Application of liquid nitrogen to freeze the tissue. Later the tissue becomes crusted and falls off.
Curettage and desiccation: The doctor scrapes or shaves off part of the lesion, then applies heat or a chemical agent to stop bleeding and kill any remaining AK cells.
Laser surgery: The use of intense light to destroy the AK tissue.
Topical treatments: There is a variety of topical treatments, including topical chemotherapy, chemical peel, and topical immunotherapy.
Photodynamic therapy: This involves using a light-sensitizing topical agent, then uses strong light to activate it, destroying the AK tissue while sparing healthy tissue.
Your doctor might also recommend combining two or more treatments. Some of these treatments increase sun sensitivity; check with your doctor and be especially diligent about using sun protection during the treatment period.