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Actinic Keratosis

Actinic keratosis (AK), also known as solar keratosis, is the most common type of precancerous skin lesion. Exposure to sunlight over the years irreversibly damages the cells in the skin. After enough exposure the damaged skin begins to form rough, scaly spots called actinic keratoses (AKs) which may never heal. These AKs are precancerous and if neglected, may become skin cancer.  

The more time individuals spend in the sun over the years, the greater their odds of developing one or more AKs. That is why these lesions are more common in older people and outdoor workers. People with fair skin, blonde or red hair, and blue, green, or grey eyes are at greater risk because they are more susceptible to sun damage. But anyone can develop these precancerous growths, just as anyone can develop skin cancer.

The more AKs that are present, the greater the chance that one or more may turn into skin cancer. Once an AK becomes a cancer and invades more deeply into the skin, it may bleed, ulcerate, become infected, and even spread to internal organs. 
How to spot an actinic keratosis
AKs typically occur on the face, lips, ears, scalp, neck, back of the hands, shoulders, forearms, and back--the parts of the body most often exposed to the sun. Ranging in size from 1 mm to 1 inch (most often about 2 mm to 4 mm) in diameter, AKs usually appear as small crusty, scaly, or crumbly bumps or horns. The base can be dark or light skin-colored and may have additional colors such as tan, pink, or red onze website.

Early on, AKs may come and go. Sometimes, they are more easily detected by feel than by sight. They are dry and rough to the touch and may be raw and sensitive. Occasionally, AKs itch and cause a prickling or burning sensation. They can also be inflamed and surrounded by redness. In rare instances, they may even bleed.


When it is not clear whether a growth is a precancerous AK or a fully developed skin cancer, it may be necessary to remove a growth for microscopic examination (biopsy). The appropriate treatment can then be determined. Dr. Schwartz offers several treatment options for patients with AKs, some are discussed below.

    -Broad Band Light:  see broad band light section(Radiancy)

    -Levulon Kerastick (aminolevulinic acid HCI) for topical solution, 20%.

Levulo is an advanced treatment for nonhyperkeratotic AKs (AKs that have not become enlarged and thick) of the face and scalp. The system is unique because it effectively triples the effect of broad band light therapy alone. The treatment regime includes applying the solution, an acid that occurs naturally in the body, to make the AKs more sensitive to light. After waiting 1 hour, the patient returns to the dermatologist’s office where the AKs are exposed to a broad band light. This light then destroys the Aks.   Eight weeks after treatment, it had cleared 100% of AKs in about two out of three patients. The system more effectively cleared AKs on the face than those on the scalp.

Sun damage is permanent and accumulative. Once sun damage has progressed to the point where actinic keratoses have developed, new keratoses may appear even without further sun exposure. It is important to avoid excessive sun, but it is not necessary to totally deprive yourself of the pleasure of being outdoors. Reasonable sun protection should be your aim.

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               Thank you, Dr. Rob Schwartz


These statements have not been evaluated by the Food and Drug Administration.
They are the sole opinion of Dr. Schwartz and are not intented to diagnose, treat, cure or prevent any disease.

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