What are actinic keratoses?
Actinic keratoses (AKs for short), or solar keratoses, develop after repeated exposure to the sun. Your skin “remembers” all the sun damage it has had since you were a child including sun bathing, playtime, yard work, vacations, sporting activities, and sunlight that hit your skin going to and from your normal daily activities.
AKs are scaly or crusty spots on the skin that may be tan, pink ,or red. They feel rough and are often easier felt than seen. They may itch or be prickly or feel tender.
One in six people will develop an actinic keratosis in the course of a lifetime, according to the best estimates. Older people are more likely than younger ones to have actinic keratoses, because cumulative sun exposure increases with the years.
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Should actinic keratoses be treated?
Yes. Actinic keratosess can be the first step in the development of skin cancer, and, therefore, are precursors of cancer or precancers. To be on the safe side, AKs are treated to prevent them from developing into more serious things, such as squamous cell carcinomas.
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How are AKs treated?
The most common method of treatment is to freeze them with liquid nitrogen. This is only uncomfortable for a few minutes and causes the skin to separate between normal skin and the AK. The AK will peel off when the skin underneath is healed. This can take a few weeks. People with extensive AKs may be treated with a cream (such as Efudex or Carac) for a number of weeks. The skin may become red, raw, and uncomfortable. Levulan is a solution that is applied to the affected skin in the office. The Levulan incubates and then, a light source is used to activate it, removing AKs, over a few days. There are also other less commonly used treatments.
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Should I follow-up?
Yes. An AK is skin cancer's warning signal. Heed that signal. Once your skin has had enough sun damage to develop an AK, you have an increased chance of developing more AKs and an increased risk for developing skin cancer. Come in if new spots appear.
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Can AKs be prevented?
Yes and no. Even if you could avoid ALL sun exposure in the future, you probably will still see AKs develop because of the damage already done. You can avoid aggravating the problem by protecting yourself from the sun. This includes wearing protective clothing (broad-brimmed hats, long-sleeved shirts), wearing a sunscreen with an SPF of 30 or higher, and limiting outdoor activities between 10 am and 4 pm.
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