What is an actinic keratosis?
An actinic kerstosis is a precancerous lesion that is caused by sun damaged skin cells. The lesion is usually scaly, rough, sandpaper feeling, and on a red base. It usually occurs on the face, scalp (especially those of us getting thinner on top), forearms and hands because these areas are most exposed to the sun. When it occurs on the lips it is called actinic cheilitis. About 10% of actinic keratoses develop into squamous cell carcinoma. Therefore it is very important to get these lesions treated early.
Are they harmful?
Some actinic keratoses may cause pain but most are asymptomatic, meaning that they do not cause any discomfort. However, at times they can be painful, bleed, or even itch. These lesions have not yet turned cancerous but must be treated regardless if they are symptomatic or not given their potential to develop into squamous cell carcinoma. A squamous cell carcinoma is considered a skin cancer and has the ability to cause local invasion, damage, and in some cases metastasize to other organs in the body including the lymph nodes.
Are they preventable?
Yes, these lesions can be prevented by being careful with sun exposure. The worst actinic keratoses lesions I have seen are in those with high and long term sun exposure such as farmers, sailors, golfers, construction workers. These can be generalized across the face, scalp, arms, and hands. To prevent these please exercise excellent sun protection including avoiding midday sun from 10 AM to 2 PM, wearing sunscreen and sun protective clothing, and also seeking the shade when possible. The better you protect yourself today the better off you will be tomorrow
How do you treat them?
Actinic keratoses are treated via different modalities. The most common is using liquid nitrogen to freeze the precancerous cells. Liquid nitrogen is incredibly cold (-320 F) and is used by the dermatologist to target these precancers. If the actinic keratoses are numberous in numbers then a different modality can be used. These modalities are called field treatments because they treat the entire field instead of spot treating a few lesions. These field treatments include topical medications, chemical peels, and photodynamic therapy. Photodymanic therapy is one where the doctor or his assistant apply a special medication topically to the affected areas, after a period of incubation, the patient is placed under a special blue light, the medication is then activated destroying the pre-cancer cells. The patient will need to stay out of the sun light for 2 days. Dr. Al-Dabagh will determine the best course of treatment which is unique to every patient because there are risks and beneftis associated with each treatment.