AKs Are NOT OK! Facts About Actinic Keratosis

Remember those carefree childhood summers, running through the neighborhood, splashing in the pool, mowing the lawn, lounging on the beach, or helping out on the farm? Back then, we didn’t think twice about skipping the sunscreen or going without a hat, unaware of the damage the sun was quietly inflicting on our young, unprotected skin. Unfortunately, those carefree days can catch up with us as we age. What we didn’t realize while we were joyfully playing under the sun was that its rays were secretly altering our skin cells, setting the stage for future issues.


What is an AK?

As early as your 40s or 50s, these previously silent mutations may begin to manifest as lesions called actinic keratosis (AK). AKs develop when the skin has been badly damaged by ultraviolet (UV) light from the sun or indoor tanning, and many times will look like crusty areas on the skin. These precancerous lesions are typically easier to feel than see and most commonly develop in areas where we have had chronic sun exposure, such as the face, scalp, and backs of hands and forearms. The lesions that develop may sting and tend to regrow even after being “picked off.”

Actinic keratosis represents areas of mutated keratinocytes that multiply faster than the rate of normal skin and, therefore, develop localized crusty spots. According to the American Academy of Dermatology, an estimated 40 million people in the United States develop actinic keratosis every year. About 1 in 10 of these lesions evade detection and become a skin cancer called Squamous Cell Carcinoma (SCC). Fortunately, the body’s immune system is capable of finding and destroying most of these mutated keratinocytes before they can become skin cancer.

Besides crusty, rough patches, AKs can also look like rough bumps that look like pimples, scaly rough patches that look like a rash, and they may be red, pink, or gray. You might also see them on the lips, manifesting as dry, scaly lips that never seem to heal or scaly white patches on the lips. Lastly, they may become a growth that looks like an animal horn.


How To Avoid Developing AKs

Our goal in preventing actinic keratosis is primarily to prevent the radiation exposure that leads to AKs and to treat existing AKs so that they cannot develop into SCC. Sun protective clothing (including hats) along with sunscreen (Broad Spectrum SPF 30-50) is imperative in helping to prevent the radiation exposure that leads to AKs. It is never too late to start! Regardless of age or previous “sun sins,” the body’s mechanisms for detecting and destroying these unwanted mutations are always at work and can successfully target these areas if the skin is not constantly being exposed to additional mutagenic radiation.


Treatment Options for Existing Actinic Keratosis

For those lesions that do escape detection, there are multiple treatment options. At Dermatology Associates of Northeast Georgia, our Dermatology Providers can assess the skin and the extent of involvement. Solitary lesions can be treated successfully with the localized application of liquid nitrogen. Areas of more widespread involvement typically require a “field treatment,” which can be accomplished through the application of one of several creams or the use of an in-office procedure called Photodynamic Therapy (PDT). A crusty lesion that regrows no matter how many times it is picked off warrants an evaluation and potential treatment.

Here are some of the treatment options available:

Cryosurgery

Cryosurgery is a common treatment for actinic keratosis (AK) that involves freezing the abnormal skin cells to destroy them. Typically using liquid nitrogen, these extremely low temperatures destroy the targeted areas. It is effective in treating superficial AK lesions.

The procedure involves applying liquid nitrogen directly to the actinic keratosis lesion using a spray device or cotton-tipped applicator. The treated area typically blisters or crusts over, and the damaged tissue eventually falls off as the skin heals, which usually takes a few weeks.

Curettage

This method is often used for thicker or more isolated AK lesions and is a quick, in-office procedure with minimal downtime. The area with the actinic keratosis is usually numbed with a local anesthetic to ensure the patient is comfortable during the procedure. Your Dermatology Provider then uses a special instrument (curette) with a sharp edge to scrape away the damaged skin cells of the actinic keratosis. The curette is carefully used to remove the AK lesion, along with a small margin of surrounding tissue.

After the lesion is scraped away, your Dermatology Provider may use a technique called electrodesiccation. This involves applying a low-level electrical current to the treated area to destroy any remaining abnormal cells and to help control bleeding.

Photodynamic Therapy

Photodynamic therapy involves a professional applying a light-sensitizing agent to the affected area of the skin. Once the skin is primed, a strong red or blue light is applied to activate the solution and destroy the cancer cells without damaging the surrounding healthy skin cells. After receiving photodynamic therapy, it is important to protect the sensitive treated area from sunlight or intense indoor light for up to six weeks after the procedure.


If you have areas on your body that you believe might be actinic keratosis, don’t put off having them evaluated by one of our skilled Dermatology Providers. Dermatology Associates of Northeast Georgia has locations in Gainesville, Dahlonega, and Demorest. You can book an appointment online with one of our experienced Dermatology Providers.