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East Central Indiana

Actinic Keratosis

Actinic Keratosis

Diagnosis Information: Actinic Keratosis (AK)

What causes actinic keratosis?

Actinic Keratoses are caused by repeated, prolonged sun exposure over decades causes skin damage, especially in fair-skinned persons. Sun-damaged skin becomes dry and wrinkled and may form rough, scaly spots called actinic keratoses. These spots remain on the skin even though the crust or scale is picked off. They feel rough to the touch and may be painful on pressure. Susceptible persons usually have more than one keratosis, and sometimes have dozens. Treatment of an actinic keratosis requires removal of the defective skin cells. New skin then forms from the deeper skin cells, which have escaped sun damage.

Why treat actinic keratosis?

Actinic keratoses are not skin cancers. However, they are pre-cancerous; that is, they may turn cancerous, and therefore, they should be removed.

What is the treatment?

Some actinic keratoses need to be removed surgically. Liquid nitrogen may also be used to destroy actinic keratoses, by freezing them. When there are many keratoses, we may use a topical cream or liquid, such as Imiquimod, 5-Fluorouracil or Picato. Early keratoses may respond to topical tretinoin (Retin-A). There is also a treatment called the Blu-u. One of our physicians would be happy to talk with you about which treatment would be best for you. If it appears that the keratoses may have become cancerous, we prefer to surgically remove the growth and examine it microscopically.

How can actinic keratosis be prevented?

Once sun damage has progressed to the point where actinic keratoses develop, new keratoses may appear even without further sun exposure. However, we do recommend the daily use of SPF 30 sun screen to all exposed skin. It is not necessary to "go overboard" and deprive yourself of the pleasure of being outdoors. Reasonable sun protection should be your aim.