What Is Actinic Keratosis?
It was a Saturday evening and things were slowing down in the pharmacy when a familiar customer approached the consultation window with a question. It was "Tom" (not his real name, of course). Tom was a 48 year old red-headed, fair skinned adult male. He was an outdoor enthusiast, and having done quite well in the real estate market (prior to the recent collapse) he had plenty of free time in the summers to enjoy the sunshine, sandy beaches, river kayaking and mountain biking that New England has to offer.
Typically Tom would greet me with a smile and something like "Hey Jason - when are you going to take a day off so we can paddle the Blackstone River together? You know what they say about 'all work and no play'?" I would usually respond by reminding him that SOME of us still had to work for a living.
But tonight Tom wasn't smiling. I could read a slightly worried look in his eyes as he glanced around, waiting while I bagged up Mrs. Jones medicine. As I approached him in the consultation area he pointed to a spot on his neck. "What do you think this is?" he asked.
Looking more closely I examined the spot. It was small (about the size of a pencil eraser), relatively flat, rough-looking spot, and brownish-red in color. It looked a little like a wart, but the neck is not a very common location for a wart.
"When did you notice that?" I asked.
"Just last week" he replied. "Do you think it could be cancerous?"
I could tell Tom was very concerned. I smiled and relaxed, trying to not communicate any worry or fear. He had enough of that already. "Listen," I said to Tom, "there are a lot of things that could cause a spot like that to appear. It's probably nothing to be worried about at all. However, I think you need to make an appointment with a dermatologist. . It may not be anything serious, but spots like that should always be looked at by a specialist in my opinion. It may be something known as Actinic Keratosis."
Tom agreed to make an appointment as soon as possible.
Several weeks later Tom was back in the pharmacy. After a visit to his dermatologist, Tom had discovered his legion was indeed Actinic Keratosis.
Tom learned this about Actinic Keratosis:
- Actinic Keratosis presents itself as small, often scaly patches of skin and vary in color from pink to red to brown
- Actinic keratosis is sometimes referred to as Solar Keratosis (due to the involvement of the sun as a cause of this condition)
- Those at greatest risk are adult men with fair skin and red or blonde hair (like Tom)
- High sun exposure, especially during childhood, also increases risk
- Skin areas with the most sun exposure are the sites most likely to be affected (face, neck, hands, ears and forearms)
- Actinic keratosis should be examined by a dermatologist, particularly if the patches are painful or irritated
- Actinic keratosis is considered a "pre-cancerous" condition of the skin. It is not cancer, but it may develop into a cancerous lesion
When Tom came back to the pharmacy he brought with him a prescription from his dermatologist. The prescription was for Solaraze gel, just 1 possible topical treatment for this condition.
Tom learned that Actinic Keratosis does not always have to be immediately treated. But if the spots are bothersome or painful or if the dermatologist believes they should be removed, several treatment approaches are available.
Topical Prescription Treatments for Actinic Keratosis:
- Fluorouracil creams (such as Carac or Efudex or Fluoroplex or generics)
- Imiquimod creams (such as Zyclara)
- Solaraze gel (diclofenac 3%)
Other Treatments for Actinic Keratosis:
- Local freezing of the skin (as often done with warts)
- Chemical Peeling
- Scraping (known as "curettage")
- Laser treatments
Tom also learned a few things about preventing Actinic Keratosis. From this point forward he was determined to be more consistent in applying these important prevention techniques:
- Use a good suncreen of at least SPF 30, and apply before going outdoors. Cover all exposed areas of the body, and re-apply often.
- Wear a hat to help shade your face and neck from the sun
- If possible, avoid exposure to sunlight during the hottest periods of the day (10:00AM to 3:00PM)
- Choose clothing that will provide addtional coverage of exposed skin while outdoors
- Regularly perform self-checks for unusual spots or lesions on the skin. Pay close attention to those spots that are new, or appear to have changed in shape, size or coloration.
I hope the preceeding account has helped explain the causes, treatments and ways to lower your risk for Actinic Keratosis.
For more information, check out these websites:
Actinic Keratosis - From the National Institute of Health
Actinic Keratosis - From the Skin Cancer Foundation