Actinic (solar) keratosis

What is it?

Actinic keratoses, also known as solar keratoses, are a common condition where rough, scaly patches appear on the skin. They are caused by long-term exposure to the sun's harmful ultraviolet (UV) rays. These patches are usually seen on areas of the body that are frequently in the sun, such as the face, neck, scalp, ears, arms, and hands. Actinic keratoses are more common in older adults, especially those with fair skin.

How do I know if I have them?

If scaly patches on your skin start to appear on your skin, you may want to see a health care professional for a diagnosis to get the right treatment. During a physical exam, the doctor will have a close look the affected skin and may use a special magnifying tool called a dermatoscope to be able to see the area better.

In some cases, a small sample of the skin may be taken for further analysis. This is known as a skin biopsy and it helps to confirm the diagnosis and rule out other skin conditions that may have simliar symptoms.

How to treat it

Actinic keratosis is not dangerous, however it can turn into cancer that can be dangerous. It is important to treat solar keratosis once it is diagnosed because when it is left untreated, there is a chance that it could turn into a type of skin cancer called squamous cell carcinoma. There are a few different treatments that may be recommended for you. The choice of treatment depends on the number, size, and location of the patches.

Common treatment methods include

• creams or gels that contain medications to remove the patches
• cryotherapy - This is a common method of treatment by freezing the patches with liquid nitrogen. Once the patches of damaged skin peels off from the treatment, new, healthy skin will grow back in its place.
• cutting/scraping - A device called a curet is a small tool with a loop on the end that is used to scrape off the patches of affected skin.
• laser therapy - Laser treatment can kill the patch of skin to allow new skin to grow it its place.
• photodynamic therapy - This is where a product that is sensitive to light is applied to the affected patches of skin, and then light is directed at the patches which causes the skin to die.

It is important to follow the health care professional's instructions and attend regular follow-up appointments to monitor the progress of the treatment. In rare cases you may need to follow up with more treatment to make sure all of the patches have been destroyed.

How do I avoid getting these patches in the future?

Preventing actinic keratoses is crucial to reduce the risk of developing skin cancer later in life. Here are some good rules of thumb that you can follow today to help your future self:

• Limit your time in the sun, especially during peak hours of the day when the sun's rays are strongest.
• Wear protective clothing, such as wide-brimmed hats, long-sleeved shirts, and sunglasses.
• Apply sunscreen with a high sun protection factor (SPF) of 30 or higher, and reapply it every 2 hours or after getting wet, such as swimming or sweating.
• Seek shade whenever possible, especially during the hottest parts of the day.