Symptoms of actinic keratosis

Actinic keratoses are mainly found in places that are exposed to increased light, i.e. the forehead or a bald head, auricles, cheeks, bridge of nose, lower lip, forearms or back of the hand. Isolated or several foci can occur at once, which can have a diameter of 1 mm to 2.5 cm. First, there are sharply defined, round or oval reddened foci with a rough surface, this is the erythematous type of actinic keratosis.

In the course of time, the increased keratinization (hyperkeratosis) becomes more pronounced and a yellowish, dirty brown thickened keratosis develops, this is the keratotic type. Experts speak of a cornu-cutaneum type when there is a very strong horn formation. Furthermore, the pigmented type can be distinguished, in which an increased or decreased skin colouring (pigmentation) can be observed.

In the lip area, the cornification disorder is called actinic cheilitis. As a rule, the patients are free of symptoms, sometimes a feeling of tension, burning or itching is felt. In addition to the pigmentation disorders, telangiectasias also occur, whereby these are dilated skin vessels that are more prominent in the affected area.

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The nose is a common location for the occurrence of actinic keratosis. Especially the bridge of the nose is often affected. This is due to the following reason: The bridge of the nose is one of the so-called sun terraces of the skin.

These are skin areas that are particularly exposed to sunlight. The bridge of the nose, as a protruding bony structure, is more affected by sunlight than, for example, the lower back. The nose is also often simply forgotten when applying sunscreen, as are the backs of the hands and feet.

Furthermore, the nose is not protected by clothing, as is the case with other skin regions. This is why actinic keratoses develop particularly often on the nose. However, the type of skin changes does not differ from other skin areas and is treated in the same way.

The nose can have individual or contiguous, extensive skin changes. The extent of the actinic keratoses then ultimately determines the therapy. A large-area excision of the skin changes is often problematic on the nose, so that treatment with ointments and gels is often preferred in the case of extensive infestation.

A photodynamic therapy is also very well suited, as the cosmetic result on the nose is particularly satisfactory. Actinic keratosis represents a special form and is also called actinic cheilitis. It is an inflammation of the lip surface provoked by UV light.

Mostly the lower lip is affected. Furthermore, men have actinic keratosis on the lip more often than women. An important risk factor for the occurrence of actinic keratosis on the lips is smoking.

It is often a combination of damage resulting from UV and tobacco exposure. The chronic form of actinic cheilitis can be considered a precancerous stage of cancer and can be treated with various therapy options. In case of a mild form without scaly deposits, care measures with greasy and light-protecting lipsticks are usually sufficient.

A more pronounced form requires treatment. The scalp is one of the most frequent localizations of actinic keratosis as it is often exposed to sunlight. Especially people with a bald head must pay attention to a good sun protection of the scalp.

However, this is all too often neglected. Thus, over the years, changes in the sense of actinic keratosis develop which are easily overlooked at the beginning. Individual skin changes can be removed with procedures such as icing, surgery or laser excision. If the scalp is extensively affected, treatment with ointments or photodynamic therapy is preferable.