Life-giving sunlight carries with it warmth and radiance. But prolonged exposure to sun without protection is harmful to skin and Actinic Keratosis is one of the diseases caused by sun damage. Also called Solar Keratosis at par with its close association with Sun, it is a condition which is benign by itself. But in the same breath it is important to mention that it is a pre-cancerous condition, which may manifest itself as skin cancer or Squamous cell carcinoma.
The At-Risk group of Actinic Keratosis
- It is more prevalently seen in fair skinned people, who are genetically programmed to tan poorly and susceptible to sunburn.
- It is directly caused by prolonged exposure to Ultraviolet radiation of the sun and it effect cumulatively over years. Its chances and frequency of occurrence, thus increases with increase in age.
- Also it is more likely to have an occupational bias as people with outdoor jobs are likely to have continued sun exposure.
- This same reason can explain the increased occurrence of Solar Keratosis in men than in women.
- Geographical factors also add to the occurrence of this condition, as it is observed in larger numbers in sunny countries nearer to the equator.
- In some cases, patients who have undergone organ transplant also suffer from this condition. This is accountable to immunosuppressant therapy which increases the chances of occurrence. But even in this case, sun exposure has to be accountable to a certain degree
The first signs of the disease are:
- Skin lesions of dry or rough texture
- Patchy skin, which might develop into a skin growth
- Starts as flat, scale-like patches which can develop into a hardened wart or protruding growth on the skin, much like a horn.
- Color changes around the affected area maybe seen as grey, red or pink.
- However, a lot of times, these patches are the same color as skin
As condition that arises from excessive sun exposure, it affects the skin areas most exposed to sun like the face, back, chest, back of the hands and the scalp. It may affect a particular patch of skin or occur as multiple lesions. Also, since the lesions are sometimes the same color as the skin, it is easier to feel and identify them.
As a pre-malignant condition, it is imperative that such growth or patches be examined by a medical practitioner and if identified as Actinic Keratosis, be removed. Removal of these patches or warts does not entail complicated surgery.
Some other ways it can be removed are:
- They maybe removed by electrical cauterization. Here the small patch of skin is burned to remove the infected area
- Cryotherapy where the area is frozen and removed. Liquid nitrogen is used for this purpose of 'freezing'
- In some cases, minor surgery maybe required
- As a product of modern surgical procedure, lasers and similar light sources have also been used for removal.
- In addition creams or ointments can also be prescribed which act on the areas affected and cause the scaly parts to fall off. This treatment however, can be painful as the areas become red and inflamed, causing skin irritation. Imiquimod and 5-Flourouracil are creams which maybe used for this type of treatment
- Anti inflammatory drugs of non-steroid variety like Solaraze gel may also be prescribed. This treatment is recommended to continue for 60 to 90 days for symptoms to perish
After removal, the infected area is always taken for a biopsy, to confirm the non-cancerous nature of skin. Though Actinic Keratosis is treatable, it is important to rule out the onset of cancer. That is why patients are advised continuous medical check ups to check for occurrence of future patches. It is also important to screen patients for growth or any other changes in existing ones.
It is also important to make sure that Actinic Keratosis is not confused with bumps or skin lesions like Seborrheic keratoses which are not linked to sun exposure and not pre cancerous. Confusion in diagnosis may postpone or hinder treatment.
Prevention is better than cure and Actinic Keratosis is definitely preventable. Some preventive tips are:
- Minimize sun exposure without protection
- Use good quality sunscreen with SPF of 15 or more
- Chosen Sunscreen should be one that provides protection again UVA and UBA.
- Avoid sun exposure completely around noon as ultra violet rays are most harmful around this time
- Apply sunscreen carefully to cover every bit of exposed skin, about 30 minutes before going out
- Reapply frequently especially if out swimming
- Apply sunscreen all year through, even in winters
- Wear clothes which provide additional sun protection like wide-brim hats, long sleeved shirts/blouses and long skirts/trousers.
These steps seem straightforward and simple but Actinic Keratosis is one of the leading dermatological disorders that affect fair skinned people. If left uncured it can lead to life-threatening cancer.
Prevention is thus crucial and Medical diagnosis and treatment – absolutely necessary.