Actinic Keratosis

Actinic keratosis is one of the precancerous lesions of the skin that develops as a result of exposure to the sun's ultraviolet (UV) rays over many years. It is more common in fair-skinned people, at an advanced age, and in those with heavy sun exposure.

It appears most often on sun-exposed areas such as the face, ears, scalp (especially in people with thinning or lost hair), lips, neck, backs of the hands and forearms. It usually begins as small skin-coloured, pink or reddish areas with a rough, scaly or crusted surface. Patients often feel these lesions with their hands rather than see them, describing a sandpaper-like roughness on the skin.

Most actinic keratoses may remain unchanged for years or regress on their own. However, some can over time turn into a skin cancer called squamous cell carcinoma. Because it is not possible to predict with certainty which lesion will progress, it is recommended that diagnosed actinic keratoses be treated appropriately and followed up regularly.

Dermatological examination and dermoscopic examination have an important place in diagnosis. Dermoscopy allows actinic keratoses to be distinguished from other skin conditions and the areas requiring treatment to be identified more accurately. Where deemed necessary, a skin biopsy may be performed to confirm the diagnosis. Treatment uses cryotherapy (freezing) and certain topical agents; effective sun protection, above all sunscreen, is recommended.

For patients diagnosed with actinic keratosis, protecting themselves effectively from the sun and keeping up regular dermatological check-ups is of great importance — both to prevent new lesions from developing and to prevent, or detect early, any possible squamous cell carcinoma.