Precancer of the Skin From Repeated Exposure to Ultraviolet Rays

Actinic keratosis (AK) is the most common precancer that forms on skin damaged by repeated, long-term exposure to ultraviolet (UV) rays from the sun and/or indoor tanning.

This means that if you already have an AK, you are likely to develop more AKs in the future. This puts you at a higher risk for skin cancer, since AKs can develop into squamous cell carcinoma (SCC), a common and sometimes invasive form of the disease.

The best way to prevent AK is to protect your skin from the sun. Use sunscreen with a sun protection factor (SPF) of at least 15 when you go outside, even if it’s cloudy. Seek shelter in the shade, and don’t use tanning beds or sunlamps. Even if you tan easily or have darker skin, you’re still at risk of getting skin cancer. If you have fair skin, your risk is even higher.

Have your doctor check any lesions, moles or changes on your skin. It’s a good idea to have your skin checked by a doctor every year.

Symptoms, Diagnosis & Outlook

AKs often appear as small dry, scaly or crusty patches of skin. They may be red, light or dark tan, white, pink, flesh-toned or a combination of colors. They are sometimes raised. Because of their rough texture, AKs are often easier to feel than see.

The lesions frequently arise on sun-exposed areas of the face, lips, ears, scalp, shoulders, neck and the back of the hands and forearms. Another form of AK known as actinic cheilitis appears on the lower lip.

Doctors who specialize in the treatment of skin are called dermatologists. Your Penn State Health dermatologist will ask you to answer in-depth questions about your personal and family medical history and will examine your skin using dermoscopy, which is a microscopic examination of the lesions.

Treatment options depend on how many lesions you have, where they are, your age and overall health. Options include:

  • Chemical peel: a chemical applied to the lesion causes the top skin layers to peel off. New skin generally regrows within a few weeks.
  • Cryosurgery: liquid nitrogen freezes the tissue, which eventually falls off, allowing healthy skin to emerge.
  • Curettage and desiccation: the physician scrapes or shaves off the lesion, then uses heat or a chemical agent to destroy remaining AK cells and stop any bleeding.
  • Laser: a laser beam vaporizes the AK lesion.
  • Topical treatments: topical creams, gels and solutions are prescribed for use in patients with numerous or widespread AK. The physician applies these creams and gels directly to affected areas of the skin to treat visible and invisible lesions with minimal risk of scarring.
  • Photodynamic therapy (PDT): For widespread AKs located on the face and scalp, a light-sensitizing topical agent is applied for a period of time, followed by exposure to blue or red light to kill cancer cells. PDT is especially effective as a treatment to destroy lesions without harming healthy tissue.

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Comprehensive, Compassionate Care

Penn State Health provides specialized testing, treatment and management for precancerous and cancerous skin lesions. Our medical team is consistently recognized nationally through Best Doctors in America and America’s Top Doctors awards. Our specialists also participate in worldwide conferences and speaking engagements in countries including India, Korea, Germany, Japan and others.

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The skin cancer experts at Penn State Health Milton S. Hershey Medical Center and Penn State Cancer Institute are committed to offering their patients the latest treatment options, including access to leading-edge clinical trials. Our superb clinical research team includes dedicated research nurses, clinical trial coordinators and data analysts and gives patients the opportunity to participate in the latest clinical trials. Learn more about new Penn State Health clinical trials at StudyFinder.

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