Actinic keratosis: symptoms, causes and all the risks

Actinic keratosis is a very common precancerous disease that has a higher incidence among the elderly and in those who are exposed to excessive sun. So let's get to know this dermatological problem more closely, its symptoms, causes and all the risks it can entail.

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La actinic keratosis is a precancerous pathology very frequent that it has a greater incidence among the elderly and in those who expose themselves excessively to the sun. So let's get to know this dermatological problem more closely, its symptoms, causes and all the risks it may entail.

The disease affects the outermost part of the skin, that is,epidermis and fortunately in most cases it remains limited to the superficial layers and has a benign evolution, this provided that it is readily recognized and well treated. In Europe, actinic keratosis affects 11 to 25% of the population with one higher incidence over the age of 60 (especially among men) and in subjects with fair complexion, red hair and freckles.



How can we recognize the presence of actinic keratosis? It is about small (from a few millimeters to 1-2 centimeters) but numerous injuries which appear in different areas of the body even if they are generally concentrated in those most exposed to the sun. They have special features such as the background color which is pink-gray with shaded edges that can be red and the presence of whitish scales o yellowish which, however, tend not to come off even with rubbing. The aspect is therefore basically rugged and is evident on palpation. The injuries generally do not cause discomfort, however, they can generate itch.

In summary, we must pay attention to these symptoms which are possible alarm bells of the presence of actinic keratosis:

• Appearance of small and numerous lesions

• The color of the lesions is a grayish-pink base

Wrinkled appearance due to whitish or yellowish scales on the surface of the lesions

• Itching

An expert eye already with a visual check knows how to recognize all the characteristic signs of actinic keratosis, however, it will then be the modern specific diagnostic techniques that confirm the diagnosis.



It is no coincidence that actinic keratosis is also known as solar keratosis. The ascertained cause of actinic keratoses is in fact theexcessive exposure to the sun, prolonged for years which leads to damage and degeneration of the epidermis. It is therefore about a problem of UV accumulation in the skin precisely due to excessive exposure which may be due not only to the unconscious desire for a tan at all costs but also a consequence, for example, of a job that forces you to stay all day in the sun.

In fact, it is no coincidence that keratosis appears in most cases in the areas most exposed to sunlight, including the scalp. Even those suffering from alopecia can see the typical symptoms of actinic keratosis appear.

The areas where the lesions occur most frequently are so:

• Nose


• Cheeks

• Ears

• Back of the hands

• Arms

• Scalp (in bald people)

• Lower lip

Then there are gods risk factors that increase the possibility of suffering from actinic keratosis: belong to a light phototype, advanced agea, being albino or immunosuppressed. Skin aging accelerated by the accumulation of solar radiation over the years can also cause wrinkles, freckles, solar freckles or melanoma to appear.



If actinic keratosis is recognized and treated early, it remains a local problem of the upper layers of the epidermis that is absolutely benign. In some cases though the risk is that the situation will degenerate and that this type of injury, over the course of about a decade, will go to transform into invasive squamous cell carcinoma definitely more dangerous. Fortunately, this only happens in 10-20% of cases.

The figure may seem low but it should not be underestimated as it is between 40% and 60% of squamous cell carcinoma cases are derived from an actinic keratosis undiagnosed and treated in time which has degenerated in a malignant way going to invade the skin tissues deeper. There is also the possibility that metastases can be created in other areas or organs of the body, putting the person's health at even more risk.

The risk of degeneration increases with the increasing number of lesions due to actinic keratosis present on the patient.


How can we to prevent then actinic keratosis? It's very simple! Putting all of those into action good rules that we have often reminded you about correct exposure to the sun:

Expose yourself to the sun in the cooler hours of the day

• Use a Sun protection suitable for your phototype

• Use the hair (especially for those who have little hair or are bald)

Avoid lamps and sun beds


Treatments for actinic keratosis can be of different types:

• Cryotherapy with liquid nitrogen

Photodynamic therapy

Laser nucleoside

Surgical intervention

• Local treatment with some drugs

It will be up to the doctor to evaluate the best treatment depending on the situation and the extent of the problem.

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