Actinic Keratoses (AKs) are dry, scaly, rough-textured areas that develop from years of exposure to ultraviolet (UV) light, such as sunlight. Lesions can vary in size, shape and color and will develop on any area of skin exposed regularly to UV light. Early in development, AKs seems to appear and then disappear over periods of weeks to months. Eventually with time they become persistent.
AKs usually appear after age 40 because they take years to develop. However, even teens can have AKs when they live in areas that receive high-intensity sunlight year round, such as Florida and Southern California.
Individuals with the greatest risk for developing AKs are those with fair skin, a history of cumulative sun exposure, or a weak immune system. These lesions develop on the areas of the body that have received years of sun exposure, such as the face, ears, lip, scalp, neck, forearms, and back of the hands.
When such a lesion occurs on the lip, dermatologists call the condition “actinic cheilitis” (key-LITE-iss). “Cheilitis” means inflammation of the lips. Actinic cheilitis is characterized by a diffuse scaling on the lower lip that cracks and dries. Sometimes the lip has a whitish discoloration on the thickened lip.
Millions of Americans have AKs, and the number continues to grow. In fact, AKs are so common today that treatment for these lesions ranks as one of the most frequent reasons people consult a dermatologist.
It is important that anyone with AKs be under a dermatologist’s care. When caught in the early stages, AKs and are treatable and in most cases, curable. The key to early detection is frequent skin examinations. Performing regular self-examinations and being screened by a dermatologist as needed can help detect AKs in the earliest and most treatable stages. AKs are considered the earliest stage in the development of skin cancer and have the potential to progress to squamous cell carcinoma, a type of skin cancer that can be fatal. Anyone who develops AKs has extensive sun-damaged skin. This makes one more susceptible to other forms of skin cancer, including melanoma. Melanoma is considered the most lethal form of skin cancer because it can rapidly spread to the lymph system and internal organs.
Prevention and Early Detection Key
To prevent AKs and skin cancer, the American Association of Dermatology recommends adopting a comprehensive sun protection program that includes:
- Avoid deliberate tanning. Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product. When using a self-tanning product, you should continue to use sunscreen.
- Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun.
- Generously apply sunscreen to all exposed skin. Before going outdoors, generously apply a sunscreen that has a Sun Protection Factor (SPF) of at least 15 and is broad-spectrum — protects against both ultraviolet (UVA) and ultraviolet B (UVB) rays. While outdoors, re-apply the sunscreen every two hours, even on cloudy days, and after swimming or perspiring.
- Cover up when you must be in the sun. Wear long sleeves, pants, a wide-brimmed hat, and sunglasses that protect against both UVA and UVB rays.
- Use extra caution near water, snow, and sand. These reflect the damaging rays of the sun, which can increase your chance of sunburn.
If you find a suspicious skin lesion, be sure to see a dermatologist for diagnosis. Dermatologists receive extensive medical training in skin conditions and have the experience necessary to diagnose various skin lesions. An accurate diagnosis is the first step to successful treatment.
Self-treating by picking off the lesions is not effective treatment; the lesions grow back. Since AKs have the potential to progress to squamous cell carcinoma, a sometimes fatal type of skin cancer, AKs should be treated.
