Actinic Keratosis

An actinic keratosis is a rough, scaly patch on your skin that develops from years of exposure to the sun. It's most commonly found on your face, lips, ears, back of your hands, forearms, scalp or neck. Also known as solar keratosis, an actinic keratosis enlarges slowly and usually causes no signs or symptoms other than a patch or small spot on your skin.

Over time, actinic keratoses may develop into invasive squamous cell carcinoma; according to one study of almost 7000 patients, among the small percentage of actinic keratoses that progress into squamous cell carcinoma, the length of time for this transformation to occur was approximately 2 years.Cells within actinic keratoses (AKs) show characteristic UV-induced gene mutations.Histologically AKs share features with squamous cell carcinoma (SCC). 

Actinic keratosis (AK) occurs most often in fair-skinned individuals at a rate according to cumulative UV exposure. • Frequency increases according to a number of risk factors: Increasing age, as the dose of UV is cumulative.  Proximity to the equator, as this affects UV dosage and cumulative exposure.  Lifestyle and time spent outdoors. Outdoor lifestyles, whether with work or recreation and sport, will increase risk. 

No therapy or emollient acceptable for mild AKs. • Topical treatments:  5-fluorouracil cream used twice daily for six weeks. This clears AKs and is effective for up to 12 months. Less intensive regimens avoid soreness and side-effects; however, lower doses have not been fully evaluated.  Diclofenac gel has moderate efficacy and few side-effects in mild AKs.