Actinic Keratoses

A common, potentially serious skin condition that consists of rough, red, scaly patches, crusts or sores. Actinic Keratosis are known as the early beginnings of cancer.

What causes Actinic Keratoses?

Actinic Keratosis is a result of disruption of skin cell function. This is primarily the result of UV exposure from the sun over the years. DNA alterations cause these cells to clump, enlarge and project from the normally smooth epidermal tissue.

Actinic Keratosis should be examined annually to rule out the possibility of early skin cancer. AKs tend to grow larger over time and become more difficult to remove if left unattended.

What are the chances of Actinic Keratoses becoming skin cancers?

A range of 5%-10% of Actinic Keratoses can potentially go on to become skin cancers. It is not possible to tell which ones will do this. Some will never develop into anything further and some may go away without treatment.

Do Actinic Keratoses ever turn into melanoma (a deadly form of skin cancer)?

No. While they may give rise to skin cancers like squamous cell carcinomas, they do not turn into melanomas. Nevertheless, it is important to keep in mind that people with Actinic Keratoses may be more prone to melanomas simply by having more sun damage.

How are Actinic Keratoses treated?

  • Liquid nitrogen, or "freezing off" -- usually requires repeated treatments as liquid nitrogen only affects visible lesions
  • 5-fluorouracil to activate chemical peeling Efudex. Requires continued application even when skin has been sensitized. More difficult therapy for those with sensitive skin or outdoor lifestyle.
  • Photodynamic therapy (PDT): Light activated therapy involves applying a solution which makes actinic keratoses more sensitive to any form of light. 1 to 3 treatments are recommended.
  • Fraxel Re:store A laser FDA approved for the removal of actinic keratoses
  • Immunotherapy: topical treatment with imiquimod (Aldara), an immune enhancing agent

How do I know that my AK is not cancerous?

Any non-healing or recurring AK in the same spot may need a small skin biopsy to make sure it has not turned into skin cancer. Sometimes, we will treat the AKs and recheck them in three to four weeks. Any non-healing spots may then be suspect for possible cancer.