What is Actinic Keratosis?

What Are Actinic Keratosis Symptoms?

Actinic Keratosis (or solar keratosis) cause symptoms in people, with fair skin that are prone to burning. It is a precancerous skin lesion that has the potential to become squamous cell carcinoma if left untreated. I'm just 37 and have areas on my forearms that have just been diagnosed as actinic keratoses.

What Do They Look Like?

Look at areas on your body that you think may have had extreme sun exposure over the years; your forearms, face - especially your scalp and lip, ears and nose, your hands, and perhaps your chest. You are looking for areas, some as small as a pinhead or as large as a 2pence piece that are flat, dry, rough or scaly. The colour can range from your normal skin pigment, to very light or tan and dark freckle colour. Depending on how long you have had one of these skin lesions, it may have developed into a thicker, crusty wart like growth. In just a very few cases, it can become a Cutaneous Horn, where an overgrowth of skin cells develops into a rough cone-shaped protrusion.

On both of my arms I have circular patches, quite small approximately 5-6mm wide that are very flat, scaly and range in colour from clear/skin colour to those that have blended now to the colour of my freckles. A doctor's visit shortly will confirm it. It's so important to get anything like this checked out early incase it develops further.

It is unusual for anyone under the age of 40 to have actinic keratoses as it takes many years to cause such skin damage. There is a much higher chance of developing an AK if you have grown up in a very hot climate. It is also worth noting that tanning beds put you at an extremely high risk as the UV radiation dose per visit tends to be much stronger and more intense than sunshine.

Actinic Keratosis Treatment

If there comes a time when it needs to be removed, the main methods of removal are as follows -

1. Cryotherapy - Skin growths are frozen using liquid nitrogen, resulting in them sloughing away a few days after treatment.
2. Topical Chemotherapy - 5% Fluorouracil (5-FU) gel or cream. It is well documented that this can make your skin very sore until the end of treatment. However, I believe there is a newer topical skin treatment available now called Masoprocol, which is less of an irritant but may cause allergic dermatitis in a few people.

3. Topical Diclofenac Gel - This is used as a topical chemotherapy skin treatment as it is far gentler still on the skin than 5-Fluorouracil but takes much longer to achieve results, typically two months. It is sometimes often used in conjunction with cryotherapy as the positive clearance of the site appears to outweigh cryotherapy on its own.

4. Curettage & Cauterization - The surgeon scrapes the affected area removing the tumor and sealing the damaged vessels with heat to stop further bleeding. This is only an option for small areas.

5. Photodynamic therapy (PDT) - I believe this is now the 'patients preferred choice', but from what I have researched, it is still having its own research done as there are two areas of its procedure that are under question. To me, this says that it may not be as reliable as a topical chemotherapy option. PDT involves applying aminolevulinic acid, which is a light sensitising dye, onto the affected area and exposing it to a wavelength of light. This light therapy destroys the bowen disease cells causing minimal pain and taking significantly less time than if using a topical chemotherapy cream. The guesswork I mentioned earlier is where researchers are unsure of the correct length of time between the application of the light sensitising gel and the application of the intense pulsed light, and which IPL source is most effective.

Additional Note

Please do not confuse seborrheic keratosis (barnacles, liver spots), porokeratosis and senile keratosis (senile warts) with actinic keratosis as these are typically benign skin growths that also develop with age and over exposure to harmful sun rays. I know it is very difficult to distinguish between some of the images that are on the internet and that is why I can't recommend enough that you get yourself checked if you are not sure.

UPDATE...

I have just had a diagnosis from my GP regarding the areas on my arm that looked like they could be an actinic keratosis. His opinion is that they are infact seborrheic dermatitis..what a relief. But it just shows how confusing looking at pictures and reading descriptions can be. I highly recommend you seek a medical diagnosis rather than self diagnose like I did!