What is Actinic Keratosis?
Sun exposure cause photoaging, skin damages and a significant increase of the risk for skin cancer; the most common type of precancerous skin lesion is Actinic Keratosis. Actinic keratosis (AK) causes rough, scaly spots on the skin on sun-damaged skin. They are most commonly found on areas usually exposed to the sun such as face, lips, ears, back of the hands, forearms, scalp…. Actinic keratosis lesions enlarge slowly, take years to develop and usually cause no other signs or symptoms.
Who is most at risk?
Most of the data concerning the prevalence of actinic keratosis originate from the USA and Australia nevertheless there are some recent multi country studies analysing risk factors and prevalence of the disease in Europe. In a large case control study in EU, back in 2012, as well as in more recent ones in Spain, Austria and Switzerland all the expected personal and environmental associations for risk factors were confirmed.
AK is more frequent in people with red hair (seven times higher risk) and blue eyes. The darker is the photo-type the lower is the risk for the disease. It appears on skin that has been frequently exposed to the sun or to artificial UV light from tanning machines. Therefore, the typical patient is an elderly, fair-skinned, sun-sensitive person.
Some medical treatments showed a correlation with AK but the risk linked to thiazide diuretics and other cardiac drugs need to be further explored.
How prevent and treat AK?
With an aging population it is expected that the prevalence of AK will increase and the right prevention and treatment strategies are crucial to manage the disease.
The daily use of broad-spectrum sunscreen products as well as all the recommendations to protect the skin from sun damages are essential to prevent AK but they are not adequate when the impairment is already there. For patients at higher risk of AK new products offering high photoprotection and photo-repair action (DNA repair enzymes) are recommended all the year round.
Dermatologists can suggest the right treatment strategy when needed.
There are two option available: medical therapies and surgical intervention. Medical treatment can be applied joint to photodynamic therapy. The doctors evaluate several factors choosing the appropriate cure for each patient: size, location and number of the lesions, age, occupation and medical history as well as patient compliance. Usually the prognosis for AK is very good. With the continuing surveillance of a dermatologist and the right treatment it can be managed individually at home. The progression into squamous cell carcinoma is sporadic but need to be detected as soon as possible to prevent invasive and dangerous consequences.