Actinic keratosis is the development of abnormal skin cells in the skin as a result of exposure to ultraviolet radiation. This condition is considered precancerous. Actinic keratosis occurs when the regional immune system of the skin is weakened and cannot repair cell damage due to UV rays. interest. People with fair skin who are exposed to UV rays for a long time (eg, those who work outside, live in sunny areas) have a much higher risk of actinic keratosis.
Actinic keratoses appear as multiple, flat or slightly thickened, scaly or rough surface, skin-colored or slightly reddened on the sun-damaged skin area. Sometimes they can form more distinctive shells or even horn-like structures. It occurs especially in the back of the hand and face area that is heavily exposed to sunlight. In facial involvement, it most commonly occurs in the nose, cheek, lower lip, forehead and temple parts. It is seen in white-skinned people who are exposed to the sun for a long time outdoors.
Are actinic keratoses dangerous?
Actinic keratosis is considered as the stage before the development of cancer and has the potential to develop into squamous cancer, therefore it must be treated. The incidence of squamous cell carcinoma in people with more than 10 actinic keratosis is approximately 10-15%. If actinic keratoses thicken or become scarred or have a hard floor, they should be checked. Squamase cell carcinomas appear as crater-like formations on the skin. People with actinic keratosis may develop into squamous cell cancer; They should be followed regularly by a dermatologist as they can change into basal cell cancer or melanoma.
How should actinic keratoses be treated?
Treatment of actinic keratoses is treated by removing the abnormal, damaged cells on the skin from the skin. Thus, new skin is formed with deeper cells that are protected from sun damage.
Since it will not be possible to treat all actinic keratoses, especially in skins with excessive sun damage, it is important to treat thickened and sensitive keratoses, because these types of keratoses have a higher risk of transformation into skin cancer.
What are the treatment options?
5-Fluorouracil cream: This treatment is particularly advantageous when multiple facial actinic keratosis is present. This cream is applied to the affected skin area 1-2 times a day for 2-4 weeks. The treated area is red, crusty and there is a feeling of discomfort.
Imikimod: Imiquimod is a medicine in the form of a cream. It is applied to the affected area 2-3 times a week for 1-4 months. This drug causes a tissue irritation reaction, which lasts for 3 weeks and subsides with continued treatment.
Diclofenac gel:This drug is highly tolerant and very successful in the treatment of actinic keratosis.
cryotherapy : Freezing the skin with liquid nitrogen causes water to collect under the skin, allowing the upper layer of the skin to be removed. While facial keratoses heal in 10 days after cryotherapy; On the back of the hand, this period may take up to 3 weeks. Keratoses may recur over time and may have to be re-treated.
curettage and cautery : This method is especially preferred in thick keratoses. Usually, keratoses are scraped off with a sharp instrument. Cauterization is performed for the complete treatment of keratosis or to stop bleeding. Recovery takes several weeks.
Surgical removal procedure: With this method, actinic keratoses are removed from their outer border. It is sent for pathological examination to see if the actinic keratosis has been completely removed. This method is especially important in patients with suspected cancer.
Treatment with laser:Treatment with CO2 fractional laser is another option.
Photodynamic therapy: In photodynamic therapy, a photosensitizer (sun sensitizer) called porphyrin is applied to the area with clinic keratosis beforehand. Then a strong light is applied. A burn develops in the treated area and heals in a few weeks.
How to prevent actinic keratosis?
Actinic keratoses can only be prevented by avoiding sunlight. Actinic keratoses regress when a sunscreen with a high protection factor is applied daily. This protection is very important especially for fair-skinned people working outside.