Actinic Keratosis Can Be The Earliest Signs Of Skin Cancer

When it comes to skin cancer, the next best thing to prevention is early diagnosis and cure. With squamous cell carcinoma, one of the most common types of skin cancer, a skin growth called an actinic keratosis can be the earliest sign of skin cancer. If diagnosed before they become skin cancers, actinic keratosis (AKs) can be removed using one of several new therapies and treatments.

In the past, AKs were most commonly seen in people over the age of 60. However, changes in lifestyle and the environment are responsible for the increased incidence of AKs in individuals as young as 20. I feel it is
important for everyone to be aware of the significance of these lesions.

Actinic keratosis are small, scaly spots that develop on parts of the body that have been exposed to the sun. Commonly known as “sunspots,” AKs can have a variety of appearances. The earliest form may look like nothing more than a flat, red spot. As the lesion grows larger, it may become scaly and even thickened, much like a wart. AKs are most likely to occur on the face, lips, ears, scalp, neck, back of the hands, shoulders, forearms, and back.

AKs and most skin cancer develop as a result of sun exposure. Often my patients with AKs assure me they have had very little sun-exposure since the first 20 to 30 years of life. My explanation is that despite your sun avoidance as an adult, much of the damage has already accumulated from your sun exposure as a child.

Common treatments for AKs include surgical removal, cryosurgery ( freezing with liquid nitrogen), electrodesiccation (heat generated by an electric current), and patient-administered topical chemotherapy with one of the several available creams applied at home. A promising area of treatment is the use of a class of drugs which modify the immune system of the skin and stimulate the body’s own rejection of AKs. In addition, lasers, chemical peels, and dermabrasion are sometimes used to remove certain AKs.

Although it is possible to diagnose an AK on the basis of the clinical appearance of a lesion, it can be difficult sometimes to distinguish an actinic keratosis from a squamous cell carcinoma without doing a skin
biopsy.

To prevent AKs and skin cancer, a comprehensive sun protection program including wearing protective clothing and a wide-brimmed hat, avoiding the sun at midday when the sun’s ultraviolet rays are strongest, seeking shade whenever possible, and wearing a broad spectrum sunscreen with a Sun Protection Factor (SPF) of at least 15 is recommended. My hat is not very pretty, but it offers great sun protection. Patients with a history of skin cancer should wear the highest SPF sunscreen available. I personally wear a 45, 50, 60, 70, or 100 SPF sunscreen.

Remember, simple, early treatment can cure these pre-cancerous growths before they have a chance to become skin cancer and save patients from more extensive surgery. Early diagnosis and treatment is always best for the patient.

John J. Jones, Jr. M.D.

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