Friday, September 20, 2019

Actinic Kearatosis: 42 FAQs, Risks, Signs, Treatment

What is actinic keratosis? What do you know about solar keratosis?
Actinic keratosis (AK) is a condition where premalignant small, red, rough, scaly, flat spots occur on sun-exposed areas such as the nose, ears, face, chest, forearms, and back of the hands. Risk factors for actinic keratosis include chronic sun exposure, ultraviolet radiation exposure, advancing age, immunosuppression, and fair skin. Actinic keratosis is also known as solar keratosis, precancers, and pre-skin cancers.

(2) At what age does Actinic keratosis (AKs) develop?
Actinic keratoses are most common in old aged people. AKs are extremely rare in children or young people.

(3) Why do I have more Actinic keratosis on my left side of body?
Overall, many people have more actinic keratosis (AKs) on their left face. The reason is that this side is exposed to sun during driving. As this disease is associated with UV exposure so the skin areas that are mostly exposed to sun are more susceptible to it.

Article Covers: 42 FAQs on Actinic Keratosis           Reading Time: 7 Minutes

(4) Can actinic keratosis turn into cancer? Do actinic keratoses turn into melanoma?
No. Actinic keratosis do not turn into deadly form of cancer, melanoma. However,AKs may give rise squamous cell carcinomas (SCC).

(5) What are general skin care tips that you must follow to avoid actinic keratosis?
  1. Avoid tanning beds as the UV exposure from a tanning bed can cause much damage
  2. Avoid the peak sun hours (10 a.m. to 4 p.m)
  3. Avoid staying in the sun so long
  4. Apply sunscreen with a sun protection factor (SPF) of at least 30.
  5. Examine your skin regularly
  6. Use physical sun barriers, such as clothing and sunglasses
  7. Stay indoors
  8. Use wide-brimmed hats
  9. With the help of mirrors, check your face, neck, ears and scalp and examine for new skin growths or changes in existing moles, bumps, freckles, and birthmarks

(6) What percent of actinic keratosis turns into cancer?
What are my chances of my precancers becoming skin cancers?
Only about 5%-10% of actinic keratoses may convert into cancer, but the majority of squamous cell carcinomas do begin as actinic keratosis. Some actinic keratosis can go away without any treatment.

(7) I have a very red face (flushed cheeks with pink bumps). Is it possible that my rosacea is causing AKs?
Patients with fair skin, Irish or Scottish ancestry, and light-colored eyes are overall more prone to rosacea as well as actinic keratoses. But it will not cause actinic keratosis.
Photodynamic therapy may prove helpful in your case as it can deal effectively with rosacea, broken blood vessels, and actinic keratosis.

(8) How dangerous is actinic keratosis? Is actinic keratosis deadly?
How serious is actinic keratosis?

Almost all actinic keratoses can be removed before they develop into skin cancer but If left untreated, some of these spots may progress to SCC.
A variant form of actinic keratosis known as actinic cheilitis, found on the lower lips, may turn into invasive SCC. An untreated squamous cell carcinoma can become life threatening.

(9) What happens if actinic keratosis is left untreated?
If actinic keratosis is not treated properly, it may convert into SCC (squamous cell carcinoma), and an untreated SCC can be threatening to life.

(10) What are the signs and symptoms of actinic keratosis?

Sign and Symptoms of actinic keratosis:

The signs and symptoms of an actinic keratosis may include:
  1. Actinic keratosis are usually found on sun exposed skin areas, such like face, ears, hands, lips, neck, forearms and scalp.
  2. Rough, dry or scaly patch of skin, usually less than 1 inch in diameter.
  3. Bump on the top layer of skin.
  4. Color as varied as pink, red or brown.
  5. A hard, wartlike surface
  6. Flat to slightly raised patch
  7. Itching or burning sensation in the affected skin

Actinic-Keratosis_Solar-Keratosis
Actinic Keratosis


(11) Is there a skin test, blood test, or X-ray to diagnose AKs?
Actinic keratosis is diagnosed by a physician during a skin exam. There are no blood tests or special X-rays to diagnose AKs.

(12) What does actinic keratosis look like? 
What is the appearance of actinic keratosis?
Actinic keratosis typically occur as small crusty or scaly bumps or horns mostly on the face, lips, ears, bald scalp, shoulders, neck, hands and forearms. They range in size from a tiny spot to as much as an inch in diameter. They mostly appear as:
  • Crusty patches
  • Red scaly structure
  • Raised patches
  • Sandpaper texture
(13) How to spot actinic keratosis? How to diagnose actinic keratoses?
Actinic keratosis is more easily felt than seen. A person may feel the small red scaly crusty patches of skin that are raw, dry and rough to the touch. Skin may be itchy, painful with a pricking or burning sensation. Some Actinic keratosis (AKs) may look and feel inflamed.

Color:
Actinic keratosis may be red, silvery, pink, brown, tan, or skin-colored.
Size:
They may range in size from a tiny spot to as much as an inch.
Location:
AKs are found mostly on UV exposed areas such as face, lips, ears, scalp, neck, shoulders, hands, and forearms. For your further information, actinic cheilitis is a variant type of actinic keratosis that arises on the lower lip.
Texture:
Actinic keratoses are flat to slightly raised, scaly, crusty, horn shaped, rough, or sometimes with a bump.

(14) Is actinic keratosis always scaly?
An actinic keratosis (AK) is a crusty, scaly growth caused by damage from exposure to ultraviolet (UV) radiation.

(15) What is the prevalence of actinic keratoses?

Risk factors of Actinic keratosis:

  1. Actinic keratosis is common among people who work outdoors in the sun.
  2. 80 percent of actinic keratoses develop on the areas of the skin with the most sun exposure such as on the hands, head, neck, and forearms.
  3. Have red or blond hair, and blue or light-colored eyes
  4. Using tanning beds, Indoor tanning or exposure to UV radiation increases the risk.
  5. Actinic keratoses are prevalent in fair-skinned, blue-eyed persons living in sunny climates.
  6. It is more common in men than in women and usually occur in old aged people.
  7. People with a bald scalp, thinning hair, or with sunburns are more susceptible.
  8. Person having a tendency to skin-burn in the sun
  9. People closer to the equator are more likely to have actinic keratoses.
  10. Actinic keratosis is most common in people age 40 and older.
  11. Weak immune system
  12. Living in a sunny environment

(16) How do I know that my AK is not cancerous?
Any non-healing spots are suspected for possible cancer. Any non-healing or recurring AK in the same spot may need a small skin biopsy. Physician may check the AKs in three to four weeks to make sure if these are cancer or not.

(17) How do you get rid of keratosis?
Self care remedies may help a lot although not fully. Following treatments can minimize the irritation and itching conditions;
  1. You must avoid tight clothes.
  2. Coconut oil is very helpful for the beauty and care of skin.
  3. Skin appearance can be improved by daily exfoliation.
  4. Warm baths unclog and loosen the pores.
  5. Humidifiers may also be helpful treatment option.

(18) Is coconut oil good for actinic keratosis?
Coconut oil is relatively high in medium-chain fatty acids, which make it a suitable moisturizer for the skin. Its use is very helpful in making skin soft and avoiding scaly patches.

(19) Can actinic keratosis go away by itself?
Actinic keratosis disappears only to recur. Half of the keratosis will go away on its own if one avoids sun for a few years. It is not a serious problem and can go away on its own but it must be checked as they might turn into skin cancer at some point. Actinic keratosis produces a pricking or tender sensation, especially after being exposed in the sun.

(20) Does apple cider vinegar help you to get rid of keratosis?
There is no scientific evidence that apple cider vinegar removes skin tags and scales.

(21) Can actinic keratosis come back after treatment?
Rarely, actinic keratosis comes back again after the proper treatment. It can be treated and cured completely however, there is a need for checkups for the detection of new actinic keratoses and skin cancer.

(22) Can actinic keratosis appear suddenly?
Actinic keratosis develops in the people who are in their 40s or older. The patches often grow over time. If untreated, actinic keratosis may develop into squamous cell carcinoma (SCC), which is a skin cancer type.

(23) Can you scratch off actinic keratosis?
If scratched or picked off, an actinic keratosis will return. Actinic keratoses are thought to be precancerous as if untreated, they develop into skin cancer. An actinic keratosis returns again after additional sun exposure.

(24) Can actinic keratosis be itchy?
They itch or produce a pricking or tender sensation and can also become inflamed and surrounded by redness.

(25) Should actinic keratosis be biopsied? When is a skin biopsy necessary?.
If actinic keratosis can progress into an invasive squamous cell carcinoma, then there is a need for biopsy and histological examination.

(26) Can you pick off actinic keratosis?
If it is scratched or picked off, it will return again. It usually recurs after further sun exposure.

(27) How does diclofenac treat actinic keratosis?
Diclofenac topical gel (Solaraze) is used to treat actinic keratosis. Diclofenac belongs to nonsteroidal anti-inflammatory class of drugs (NSAIDs).

(28) What is the difference between actinic and solar keratosis?
An actinic keratosis, is a crusty, scaly growth caused by damage from exposure to ultraviolet radiation. They are usually not one so you will see multiple keratoses.

(29) What is the difference between seborrheic keratosis and actinic keratosis?
Actinic keratosis has the potential of becoming cancer but seborrheic keratosis is not known to develop into skin cancer. Variants of seborrheic keratoses include: solar lentigines, stucco keratosis, dermatosis papulosa nigra, and lichenoid keratosis.

(30) What are crusty patches on skin?
Actinic keratosis start out as thick, scaly, crusty skin patches and are about the size of a small pencil eraser. There might be itching or burning in the affected area. With the time, the lesions can disappear, enlarge, remain the same, or develop into squamous cell carcinoma.

(31) Is actinic keratosis a chronic condition?
Actinic keratosis is a skin disease. In this disease, cutaneous lesions are formed on the sun-exposed areas. Some lesions, particularly SCC, may become locally invasive and destructive, potentially leading to metastasis or even death.

(32) Is actinic keratosis benign or malignant?
Vast majority of actinic keratoses remain benign, anyhow they may develop into skin cancer, especially the second most common form of the disease, squamous cell carcinoma. If you have one actinic keratosis AK, you may develop others.

(33) Can you freeze off skin cancer?
Cryotherapy is a procedure in which liquid nitrogen is used to freeze and destroy abnormal cells. Cryotherapy is usually used to treat precancerous skin conditions. Your doctor applies liquid nitrogen to the affected skin where the extreme cold causes the affected area to blister and peel. More than 1 freezing may be needed during this treatment.

(34) How long does it take for keratosis to fall off after freezing?
Liquid nitrogen may be helpful to completely remove an abnormal growth or tissue. The blister flattens within 2 to 3 days and should fall off within 2 to 3 weeks. The liquid nitrogen will sting when it is first applied to the skin. After this, the skin will blister and shed off then the skin is replaced by new skin.

(35) Can actinic keratosis be flat?
AKs growths may be flat and pink or raised and rough. Actinic keratoses can be the first step leading to SCC.

(36) What is the best treatment for actinic keratosis?
Which medication is most effective for the treatment of multiple actinic keratosis?
Single treatment may be not sufficient so combined therapies are used to deal with this.
Efudex and Aldara may cause 3-6 weeks of skin irritation, marked redness, and sensitivity. Photodynamic therapy requires about 36 to 48 hours of absolute sun avoidance after treatment and a few days of a mild sunburn reaction.

Approved medications to treat actinic keratosis may include:

  1. 5-fluorouracil (Efudex, Carac, Fluoroplex)
  2. Diclofenac (Solaraze) and hyaluronic acid
  3. Diclofenac gel (Solaraze, Voltaren)
  4. Imiguimod (Aldara, Zyclara)
  5. Ingenol mebutate gel (Picato)

These creams and gels however may produce side effects such as swelling, rashes, and redness at the site of their application.

(37) How long does actinic keratosis take to heal?
It takes around 4 to 6 weeks to heal.

(38) What is a good Actinic Keratosis treatment for sensitive skin?
For people with sensitive skin, photodynamic therapy may be a good option because it is an in-office treatment with a simple liquid application and light exposure.

(39) What is the best way to treat actinic keratoses?
It depends on the location and size of AKs. However, combination treatments involving one or two types of therapies are best.
  • If you have just one to five AKs, then freezing them with liquid nitrogen is the best method.
  • If you have very thick AKs called hypertrophic actinic keratoses then freezing is also a great choice.
  • If you have more than 10 to 15 AKs scattered on your face, forearms, or chest, then a blanket or field type therapy may prove very handy.

(40) What are the combination therapies to treat actinic keratosis (AKs)?

Combination therapies:

Your doctors may pair therapies for treatment regimens, such as:
Cryosurgery and PDT
Topical treatments and PDT
Cryosurgery and a topical treatment

Surgical and other procedures:

Methods used to remove actinic keratosis include:

Freezing (cryotherapy)/Cryosurgery:

Actinic keratosis can be removed by freezing them with liquid nitrogen. This is the most commonly used treatment for actinic keratosis. It takes only a few minutes and can be done in skin clinic. Your doctor applies the substance to the affected skin, which removes the lesions by freezing them. The extreme cold causes the affected area to blister and peel. As the skin heals, the lesions fall off, allowing new skin to appear.
Side effects may include:
  • changes to skin texture
  • blisters
  • darkening of the skin
  • infection
  • scarring
  • discoloration of the skin at the site of treatment

Scraping (curettage):

This procedure, involves the scraping of affected skin areas with the help of a device called a curet. Scraping may be followed by electrosurgery. Electrosurgery involves a surgeon using a pen-shaped instrument, to destroy and cut away the affected damaged skin tissue with an electric current. This procedure requires a local anesthetic.

Some side effects are also related to this procedure which are:
  • infection
  • scarring
  • change in skin color at infected site.

Photodynamic therapy:

Your doctor applies a light-sensitive chemical to the affected skin. Then the skin is exposed to a light that activates the chemical to destroy the actinic keratosis. The main drawback of Photodynamic therapy (PDT) is the pain experienced during its application.

(41) Is photodynamic therapy painful?
The singleday procedure is safe, noninvasive, effective, and allows treatment of large areas. But there can be burning, redness, swelling, and stinging sensation during the therapy. Especially, the treatment becomes more painful if  actinic keratosis is located on the face and scalp.

Dermabrasion:

This treatment uses a handheld device to "sand" the skin and improve its appearance. It may be painful procedure but it can be used to treat large lesions that are often too big to treat with topical treatments. It leaves the skin red and raw.

Immunomodulator therapy:

Imiguimod cream, diclofenac, or ingenol gel, works much like fluorouracil to selectively rid the skin of abnormal cells. However there may be redness, crusting, swelling and itching in the affected areas of skin.

Surgical removal and biopsy:

The lesions may be removed and examined if there is a possibility it has become cancerous.

(42) How often should I be seen and treated for Actinic Keratosis?
Every four to six months is a very appropriate interval for treatment of AKs. Sun safety is important to prevent the formation or recurrence of actinic keratosis patches. If there is no precaution made, actinic keratosis may grow unchecked and lead to squamous cell cancer (carcinoma).

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