Pre-Cancerous Actinic Keratosis

Actinic keratosis (AK) is the most common type of precancerous skin lesion. The more time individuals spend in the sun over the years, the greater their odds of developing one or more AKs. These lesions are more common in older people and outdoor workers, but anyone can develop these precancerous growths, just as anyone can develop skin cancer.

An AK is evidence that sun damage has occurred and that the individual is at greater risk of skin cancer. These lesions most often appear on skin surfaces that have been exposed to the sun or to artificial sources of UV light such as tanning beds.

The more AKs that are present, the greater the chance that one or more may turn into skin cancer. Patients may have invisible lesions on the surface. Untreated, a significant number of AKs may develop into squamous cell carcinoma (SCC), a common form of skin cancer. Actinic cheilitis, a particularly aggressive type of AK that develops on the lips, sometimes transforms into a type of SCC that can spread rapidly to other parts of the body.

Check your skin regularly; and for any lesions that look suspicious, are changing, or not healing, see your our doctors promptly.

Effective Treatment Options for AKs.

Treated early, almost all AKs can be eliminated before becoming skin cancers. Various treatments can be used effectively with little or no scarring:

  • Cryosurgery – This is the most widely used treatment for AKs. It is useful when a limited number of lesions are present. It is applied with a spraying device that freezes them without requiring any cutting or anesthesia. They shrink or become crusted and fall off.
  • Curettage and Desiccation – When the AK is suspected to be early cancer, the physician may take tissue for a biopsy by shaving off the top of the AK or scraping it off with a curette. The curette is used to remove the base of the lesion and bleeding is stopped with an electrocautery needle. A local anesthetic is necessary.
  • Topical Medications – When there are numerous lesions, topical creams and solutions are used. They treat both visible and invisible AKs with minimal risk of scarring compared with other therapies.
  • Laser Surgery – The skin’s outer layer and variable amounts of deeper skin are removed using a carbon dioxide laser. The risks of scarring and pigment loss are slightly greater than with other techniques, and local anesthesia may be required.
  • Photodynamic Therapy (PDT) – PDT can be especially useful for lesions on the face and scalp. A topical is applied to the lesion(s) at the physician’s office. The next day the patient returns and those medicated areas are activated by a strong light. This treatment selectively destroys AKs while causing minimal damage to surrounding normal tissue. Redness and swelling are common side effects of this therapy.