Actinic keratosis: symptoms
In the early stages, it is not easy for laypeople to recognize actinic keratosis: In one or more places, there is initially a sharply defined reddening that feels like fine sandpaper. Later, the horny layer thickens and thick, sometimes yellowish-brown horny deposits form. Their diameter can range from a few millimeters to several centimeters. These skin changes do not cause any discomfort such as itching or burning. However, they can bleed more easily due to the increased vulnerability.
Preferred areas for actinic keratosis are the “sun terraces” of the body. These include the bald head, forehead, auricle, nose, lower lip (actinic cheilitis), forearms, back of the hands and décolleté.
In one in ten patients, actinic keratosis eventually develops into spinal cell cancer (squamous cell carcinoma, spinalioma). You can read more about the appearance of this form of skin cancer and its precursors under Skin cancer: Symptoms.
Actinic keratosis: cause & diagnosis
How does the doctor recognize actinic keratosis?
Even the sight of the skin changes described above raises the doctor’s suspicion of actinic keratosis. To be absolutely certain, the doctor takes a tissue sample and has it examined histopathologically in the laboratory. This is the only way to diagnose solar keratosis with certainty.
Actinic keratosis: therapy
The therapy depends on the location, size and extent of the skin changes. The patient’s age and any concomitant diseases also influence the planning of treatment for actinic keratosis. Treatment and aftercare are carried out by a dermatologist. The following treatment options are available:
- Surgical removal
- Icing with liquid nitrogen (cryotherapy)
- Removal using a laser (e.g. Erbium:YAG laser)
- Removal with a sharp spoon or a ring curette (curettage)
- Application of caustic solutions (chemical peeling)
- Local chemotherapy (e.g. ointment with the cytostatic agent 5-fluorouracil, also combined with 10% salicylic acid)
- local immunotherapy (e.g. cream with the immune-activating agent Imiquimod)
- Gel with 3 percent diclofenac in 2.5 percent hyaluronic acid
- Ointment with 1 percent tirbanibulin
You can read more about the treatment of actinic keratosis and the spinalioma that can develop from it under Skin cancer: Treatment.
Actinic keratosis: Prevention
Actinic keratosis is caused by UV radiation. Prevention is therefore easy:
- Do not expose your skin to intense sunlight (especially at midday). Avoid extensive sunbathing. If possible, stay in the shade (you can also get a tan there).
- Men who are bald are particularly likely to develop solar keratosis and should therefore always wear headgear in the sun.
- It is generally advisable to protect the skin from intense sunlight with textiles.
- You should also always use a sunscreen (with a high sun protection factor).
These tips are particularly important for people with fair skin. Their skin is more sensitive to the sun than that of people with darker skin.
UV rays are not only found in sunlight, but can also be generated artificially – for example in a solarium. To avoid actinic keratosis and skin cancer, you should therefore avoid sunbeds.
