Actinic Keratosis

What is actinic keratosis? It is a scaly or crusty bump that arises on the skin surface. The base may be light or dark, tan, pink, red, or a combination of these, or the same color as your skin. The scale or crust is horny, dry, and rough, and is often recognized by touch rather than sight. Occasionally it itches or produces a pricking or tender sensation. It can also become inflammed and surrounded by redness. In rare instances, actinic keratoses can even bleed.

The skin abnormality or lesion develops slowly and generally reaches a size from an eighth to a quarter of an inch. Early on, it may disappear only to reappear later. You will often see several actinic keratosis at a time.

An actinic keratosis is most likely to appear on the face, ears, scalp, neck, backs of the hands and forearms, shoulders, and lips - the parts of the body most often exposed to sunshine. The growths may be flat and pink or raised and rough.

Actinic keratosis is one of the most common sun-induced pre-cancerous skin lesions and precursor of squamous cell carcinoma as well as basal cell carcinoma cancer. If treated early, almost all actinic keratosis can be eliminated without becoming skin cancers. (see melanoma cancer)

Individuals with light skin are most likely to develop actinic keratosis. The condition is directly associated to sun exposure, and therefore is sometimes called "solar keratosis". In fact, fair-skinned individuals living in sunny climates have over 50 percent chance of developing actinic keratosis. Individuals aged 40 and up are at high risk, with more men affected by this common, pre-cancerous condition than women. Furthermore, regardless of age, all individuals with blue eyes and or childhood freckling are at a higher risk for actinic keratosis.

Usually, lesions develop as a single, small plaque on the face of people aged 20-30 years with light coloring and significant sun exposure; they gradually progress in sun-exposed areas, such as the nose, the forehead, and the cheeks.

During periods of depressed immunity, the visible and the subclinical lesions flare and become inflammatory red and scaly. This depression of the immune system can occur following intense ultraviolet light exposure or with systemic chemotherapy for other carcinomas.

Over the years, the lesions gradually progress, and approximately 1 in 20 lesions eventually turns into invasive carcinomas. These lesions are typically the more red and inflammed, elevated, and indurated lesions. In very hyperkeratotic lesions, the invasive component of the carcinoma is at the base of the lesion and is often not seen until a physician removes the overlying plaque.

The morphology of atypical cells in both actinic keratosis and squamous cell carcinoma is identical. The risk of progression to squamous cell carcinoma (the most common form of skin cancer) is minimal. But up to 60% of squamous cell carcinoma cases begin as actinic keratosis. Regression of actinic keratosis occurs when sun exposure is decreased and mild lesions are healed.

Actinic Keratosis Treatment Options

Treatment is often indicated to prevent the cells from invading the dermis and possibly metastasizing. If a lesion exhibits evidence of possible dermal invasion, such as marked erythema (redness of the skin caused by dilatation and congestion of the capillaries, often a sign of inflammation or infection) ulceration, tenderness, bleeding, and especially induration (hardening of a normally soft tissue), a physician will consider performing a biopsy.

Medical care

As lesions progress, they can be treated with topical 5-fluorouracil. This medication is applied twice daily for a period of 3-4 weeks for facial lesions. Other body sites require longer treatment, with the arms needing 6-8 weeks. Treating the entire area of involvement is best.

During the treatment phase, the lesions become increasingly red, and small subclinical lesions become visible. This treatment can be temporarily disfiguring, with inflammatory and red ulcerations and crust formation. However, if the patient completes the treatment, the lesions usually heal within 2 weeks of stopping treatment, the complexion is smooth, and the actinic keratosis are improved.

Topical 5-fluorouracil treatment can be repeated on several occasions. The few residual lesions that are not completely cleared with 5-fluorouracil can then be treated surgically.

Photodynamic therapy (PDT) can also be used to treat multiple actinic keratoses. In this treatment, topical 5-aminolevulinic acid accumulates preferentially in the dysplastic cells. On exposure to irradiation with light of an appropriate wavelength, oxygen free radicals are generated and cell death results. Patients experience pain in the areas treated, which is similar in quantity to the pain resulting from topical 5-fluorouracil. One treatment with PDT appears to be as effective as 5-fluorouracil and may be considered in patients with contact sensitivity to 5-fluorouracil.

Surgical care

Early lesions of actinic keratoses can be treated with destruction. Cryotherapy with liquid nitrogen is the most effective and practical method for treating actinic keratoses when a limited number of lesions are present. Liquid nitrogen, applied by swab or spray, is used for several seconds. As the cryotherapy wound heals, the actinic keratosis is sloughed off. These patients may need periodic re-treatment for small recurrences or for new lesions. Often, semiannual or annual monitoring and treatment are warranted.

Physical destruction using electrodesiccation (destruction of lesions or sealing off of blood vessels by monopolar high-frequency electric current) and curettage (scrapping of tissues with an instrument shaped like a scoop or spoon) is particularly effective when a person has hyperkeratotic lesions (scaly or hardenned keratin proteins on the surface of the skin).

Chemical peels may be used in patients with a number of facial lesions.

Dermabrasion may be used.

Adverse reactions such as scarring, textural changes, infection, and pigmentation alteration rarely occur.

If a lesion does not respond to treatment, obtaining a biopsy of the lesion should be considered to be certain that the lesion is not an invasive squamous cell carcinoma.

Cryosurgery may result in wounds, require time for wound healing, and may yield hypopigmentation (white spots) or scarring and although those side effects were acceptable in the past, many people now developing actinic keratosis have little tolerance for any time for wound healing or any cosmetic changes. The best therapy is thus one that addresses minor actinic keratosis scaly formations early, and here is where BIO SKIN CARE™ plays a significant role.

BIO SKIN CARE™ action

Grinds down mild actinic keratosis and prevents the growth of new actinic keratosis scaly formations

Acts as an exfoliant eliminating dead cells and scaly lesions before they grow.

Also destroys pathogens, heals and regenerates damaged tissue.

It nourishes your skin and protects it from free radicals.

Improves the skin's elasticity, and leaves it silky soft and soothed.

BIO SKIN CARE™ is a non prescription, natural skin care remedy, with absolutely no side effects.

The active element in the cream is a natural biological ingredient, collected from live land snails, the same they use to quickly repair their own skin and shell when damaged. It is contained in the mucin secreted by the snails, (we gather it through a process that is safe for them). It is a viscose liquid that is made into an odorless white cream with no alien, synthetic chemicals. Analysis of the mucin has determined that it contains activators of skin growth factors and antimicrobial peptides. Also presents natural anti-inflammatory and immune modulating proteins, glycoproteins, glycosaminoglycans (a group of polysaccharides with high molecular weight that contain amino sugars and often form complexes with proteins. Also called mucopolysaccharide) and copper.

The results are:

A healthier appearance of the skin

A thicker skin

Normal skin color,

Normal skin texture and

A hydrated skin

Depending on the treatment method used, people may remain free of Actinic Keratosis for months and possibly years. However, individuals with significant photodamage and those who fail to minimize sun exposure are at increased risk for the development of additional Actinic Keratosis, as well as skin cancer.

Preventing Actinic Keratosis

Apply a broad spectrum sunscreen (protects against both UVA and UVB rays) that has a Sun Protection Factor (SPF) of 15 or more, every day.

Avoid deliberate tanning. Even when wearing sunscreen, sunbathing is not safe. Tanning beds and sunlamps are not safe alternatives because they too emit UV rays.

Stay out of the sun between 10 a.m. and 4 p.m. This is when the sun’s rays are the strongest. Seek shade whenever possible. If you don’t see your shadow or your shadow is shorter than you, it is important to seek cover.

Wear protecting clothing when you are on the sun.
A wide-brimmed hat is a must to protect your face and neck from the harmful rays. Wear sunglasses that provide 100% UV protection.

BIO SKIN CARE™ will not heal severe keratosis that may have already a cancerous formation