Actinic or Solar Keratoses

Solar Keratosis (also called "Actinic keratosis" and "senile keratosis") is a premalignant condition of thick, scaly, or crusty patches of skin. It is more common in fair-skinned people and it is associated with those who are frequently exposed to the sun, as it is usually accompanied by solar damage. They are considered as potentially pre-cancerous, since some of them progress to squamous cell carcinoma, so treatment is recommended. Untreated lesions have up to 20% risk of progression to squamous cell carcinoma.

Actinic or Solar Keratoses

Progressive development of these lesions occurs when skin is exposed to the sun constantly and thick, scaly, or crusty areas appear. The scaly or crusty portion is dry and rough. The lesions start out as flat scaly areas and later grow into a tough, wart-like area.

A Solar Keratosis site commonly ranges between 2 and 6 millimeters in size, and may be dark or light, tan, pink, red, a combination of all these, or have the same pigment as the surrounding skin. The lesion may appear on any sun-exposed area, such as the face, ears, neck, scalp, chest, backs of hands, forearms, or lips.

Solar Keratoses Classification

Solar Keratosis may be divided into the following types:

*Hyperkeratotic actinic keratosis
*Pigmented actinic keratosis
*Lichenoid actinic keratosis
*Atrophic actinic keratosis

Actinic or Solar Keratoses Prevention

Preventive measures recommended for actinic keratosis are similar to those for skin cancer:

*Not staying in the sun for long periods of time without protection (e.g., sunscreen, clothing, hats)
*Frequently applying powerful sunscreens with SPF ratings greater than 30 and that also block both UVA and UVB light
*Wearing sun protective clothing such as hats, long-sleeved shirts, long skirts, or trousers
*Avoiding sun exposure during noon hours is very helpful because ultraviolet light is the most powerful at that time

Actinic or Solar Keratoses Treatment

Best: Aldara cream 5%

5-fluorouracil appears to be the most effective treatment.

Various other treatments may also be used including:

*Ingenol mebutate gel for treatment of the trunk and extremities or the face and scalp, respectively. Duration of therapy is 2 days for the 0.05% gel and 3 days for the 0.015% gel
*Diclofenac sodium gel, a nonsteroidal anti-inflammatory drug, Recommended duration of therapy is 60 to 90 days
*Cryosurgery, e.g. with liquid nitrogen, by "freezing off" the actinic keratosis
*Photodynamic therapy: this new therapy involves injecting a chemical into the bloodstream, which makes the lesions more sensitive to any form of light. Laser, notably CO2 and Er:YAG lasers, a Laser resurfacing technique is often used with diffuse actinic keratosis
*Electrocautery: burning off actinic keratosis with electricity
*Imiquimod, an immune enhancing agent for topical treatment
*Different forms of surgery

Regular follow-up after the treatment is advised. The regular checks are to make sure no new lesions have developed and that old ones haven't become thicker.

Next Post: Skin Care For All Ages