Actinic Keratosis: The Risk, Cause & What You Can Do

Actinic keratosis (AK) is a very common skin pre-cancer. Understanding your risk factors along with what causes AK can help you prevent it from developing.

Being aware of your disease risk will also help you spot AKs early, when they are highly treatable. If left untreated, they can turn into squamous cell carcinoma, a type of skin cancer.

These factors increase your risk

  • History of unprotected exposure to ultraviolet (UV) radiation from the sun or indoor tanning. This includes people who work outdoors in the sun, people with a bald scalp or thinning hair and those who have had sunburns.
  • Geographic location: The closer to the equator you live, the more likely you are to have AKs.
  • Weakened immune system due to a medical condition or medications.
  • Fair skin: While anyone can develop AKs, they occur far more frequently in people with fair skin.
  • Age over 40: AKs are most common in people age 40 and older.

Actinic Keratoses mainly affect fair skinned people—especially individuals with red or blonde hair, blue or green eyes, or skin that freckles or easily burns– on the face, ears, chest, arms, and hands. They are sandpaper-like, rough, red spots that are more easily felt than seen. You can think of them as precancerous sunspots. Left unchecked, some AKs will turn into squamous cell carcinomas.

Living in a sunny climate close to the equator where the UV rays are strong most of the year means more exposure to the harmful effects of the sun. Thus, the likelihood of getting AKs is higher for people who live in regions close to the equator.

Regardless of climate, anyone who spends a lot of time outdoors without protection risks developing one or more AKs. Even when it’s overcast, about 80 percent of UV rays can pass through clouds.

There are a few different treatments for AKs. If you have just a few, we can use an ice cold spray called liquid nitrogen to freeze them off. When there are many, we might prescribe a topical field treatment like fluorouracil or imiquimod. If an AK does not respond to treatment, you will likely need a skin biopsy to make sure it hasn’t already become cancerous.

If you are prone to AKs, it is important to protect your skin from the sun by seeking shade and with sunscreen, hats, and protective clothing. And be sure to perform monthly self-exams and visit your dermatologist annually for a thorough professional skin exam.

For skin screening appointments with our board certified dermatologist, Dr. Maryann Mikhail, please call our office at 954-666-3736.