Actinic Keratosis
Scaly spots on sun exposed areas. Risk is about 1% per-year of becoming a skin cancer.
What is an AK (actinic keratosis)?
Actinic Keratoses (AKs) are pre-cancer spots. They happen because of accumulated UV damage (sun exposure). Essentially, UV radiation causes DNA damage which leads to these cells multiplying too quickly – the extra cell growth leads to more dead skin cells on top of the skin – which is why they are scaly. They represent the pre-cursor to Squamous Cell Carcinoma (SCC) the second most common skin cancer.
What does all this mean?
Don’t panic! While this does show that you have had a good bit of sun exposure it isn’t the end of the world. You can still
go outside (preferably with better sun protection). But, it also means you should see a dermatologist once per year as your risk for making a skin cancer is increased. Seeing a dermatologist once per year, or sooner if you see a spot you are concerned about, allows you to have skin cancer detected while it is still early/small.
How do you treat AKs?
For most people treatment involves simply freezing the pre-cancerous spot. This essentially destroys the cells that are too damaged and are then replaced by healthier cells. Acid peeling the spots is also an option, although less common. If you have many AKs, another very effective option is a “field treatment”.
What is a Field Treatment?
The way I like to think of it is this:
If you have just a few weeds in your yard it would be easiest to just pull the weeds and move on – freeze the spots.
If you have a number of weeds in the lawn (or just hate pulling weeds – freezing) then spraying weed killer over theentire lawn would be easiest/best. The field treatment is the weed spray.
There are many types of field treatments. Common treatments are:
Topical creams – Efudex, aldara, etc
Light based treatment (aka photodynamic therapy) – Blue light or red light
Chemical peels – typically a Jessner/TCA – typically not covered by insurance
Source: American Academy of Dermatology (link - https://www.aad.org/public/diseases/skin-cancer/actinic-keratosis-overview)
For Physicians only (or patients of Dr. Contestable) – “AK and Field Treatment – Patient Handout”
“Efudex / Calcipotriene – Patient Handout”