Actinic Keratosis (AK) are potentially pre-cancerous lesions on sun-damaged skin. They feel like sandpaper patches (thin AK) or sharp bumpy thorns (thick AK) on the skin. They may be painful or irritated because AKs are abnormal skin cells. Under the microscope, AKs show many of the same changes seen in squamous cell cancer (SCC). Untreated, each AK has a small chance of becoming an SCC. Your risk of having an SCC increases if you have a lot of AKs or if your lesions are thick and growing rapidly.
Many early AK will go away if you avoid repeated sun exposure and wear sunscreen consistently. Think of AKs in the setting of a boxing match. If your cells get constantly hit by the sun, then one of the hits may be a knockout and an SCC then develops. However, if you are able to dodge those hits (wearing sunscreen and avoiding unprotected sun exposure), then your cells have a chance to defend itself and recover.
Fortunately, there are many effective treatments for AK. Your options range from freezing, creams, or light treatments. Which option is best for you depends on many factors (number of Aks, type of Aks, convenience, etc).
- If you have a few Aks, then freezing them is often best. Freezing involves a cold spray with liquid nitrogen that physically destroys the abnormal cells. A blister may form and the Aks slough off after 2-3 weeks.
- If you have many Aks, then combination treatments work best. Freezing is done for the thick Aks and either creams or photodynamic therapy (Blue Light) for the remaining thin Aks.