Northwestern
Skin cancer institute
Skin cancer institute
Do you know how to spot an actinic keratosis (AK) lesion on your skin? According to skincancer.org, approximately 58 million Americans are affected by actinic keratoses. The more you have been exposed to the sun, the greater your chance of developing actinic keratosis. Unfortunately, the effect of sun exposure is cumulative, so those long days out in the sun when you were younger can add up to a significant amount of sun damage. Even if you didn’t suntan much or have a history of sunburns, years of exposure from playing sports outside, walking your dog, or driving in your car can add an increased risk factor toward developing precancers such as AK.
What Are Actinic Keratoses (AKs)?
Actinic keratoses (AKs) are considered the first step in the development of skin cancer. Detecting an AK early can give you the opportunity to treat the lesion and prevent skin cancer before it starts. If left untreated some actinic keratoses may progress to squamous cell carcinoma. While most AKs are benign, the majority of squamous cell carcinomas arise from AK lesions.
How do you know if you may have an actinic keratosis lesion? AKs are usually found on areas of the body that are exposed to the sun. The most common places they develop are the face, ears, scalp, back of hands and forearms. Actinic keratoses can vary widely in appearance. Some AKs can be as small as a pinhead, while others are larger than a quarter. They can be thick, rough-textured, dry, scaly patches or they can appear as red bumps with a tan crust that keep coming back and don’t heal.
Actinic keratoses occur due to long term exposure to ultraviolet light, such as the sun, so they generally begin to appear after the age of 40. If you suspect you may have an AK, it is very important to see your dermatologist for treatment to prevent cancer growth.
There are several different treatments for AKs ranging from topical creams to light therapy. The type of treatment depends on how many lesions you have, where they are located, your age and overall health. Your dermatologist may decide to scrape or shave off the lesion, and/or use heat or a chemical agent to destroy any remaining AK cells, or they can use liquid nitrogen to freeze the tissue, which eventually falls off, allowing healthy skin to grow. However, when a patient has a large surface area with multiple AKs, your dermatologist may recommend either topical creams, liquid nitrogen or Photodynamic Therapy.
Basal cell carcinoma (BCC) is the most common type of skin cancer; it occurs most frequently on the head and neck, with the rest mainly on the trunk and lower limbs. BCCs can look like red patches, pink growths, open sores, shiny bumps and/or growths with slightly elevated rolled edges. BCCs are frequently found in fair-skinned people and rarely occur in dark-skinned individuals. In patients with darker skin, about half of BCCs are pigmented.
BCCs usually do not grow quickly, but this does not mean treatment should be delayed. If allowed, these lesions can become disfiguring and dangerous. BCCs rarely metastasize (spread) to other organs. If untreated, the cancer will often begin to repeatedly bleed and crust over, and can extend below the skin to the bone and nerves causing considerable damage.
If you’ve been diagnosed with a BCC that has not spread there are effective outpatient treatments. The preferred treatment of most BCC is the MOHS procedure. Other treatment options can also be discussed depending on the tumor size, location and depth, as well as patients age and overall health.
Squamous cell carcinoma (SCC) is the second most common skin cancer; it is primarily found in fair-skinned people and rarely in dark-skinned individuals. They are typically located on the rim of the ear, face, near the mouth or the trunk and sun-exposed areas. SCC can also occur in other areas of the body, including the genitals.
SCC may appear as a firm bump, a red scaly patch, wart-like skin, or raised growths with a central depression. SCCs can develop into large masses and become invasive, leading to extensive tissue destruction and a possible risk of metastasis. Therefore, it is important to get early treatment of SCCs.
If you’ve been diagnosed with a SCC that has not spread there are effective outpatient treatments. The preferred treatment of most SCC is the MOHS procedure. Other treatment options can also be discussed depending on the tumor size, location and depth, as well as patients age and overall health.
Melanoma is a serious form of skin cancer. While it is less common than BCC and SCC, it is the most dangerous of all skin cancers. Melanoma begins in melanocytes, the cells throughout the skin that produce the pigment called melanin which makes the skin tan; clusters of melanocyte are what make up moles.
Melanoma may appear suddenly, or begin in or near a mole or another dark spot in the skin. Is it important to know the location and appearance of the moles on the body and to detect changes early. Since melanoma cells can continue to produce melanin, this skin cancer often appears in mixed shades of tan, brown, and black; although, it can also be red or white.
Any changing mole must be examined by a dermatologist. Early melanoma can be removed while still in the curable stage; melanoma readily metastasizes, making early detection and treatment essential to increase survival rates. Excessive sun exposure, especially sunburn, is the most important preventable risk factor for melanoma. Fair-skinned individuals are at particular risk, but heredity also plays a part. A person has an increased chance of developing melanoma if a relative or close family member has had melanoma. Atypical moles, which may also run in families, and having a large number of moles can also serve as markers for people at increased risk for developing melanoma.
Dark skin is not a guarantee against melanoma. People with skin of color can develop melanoma, especially on the palms, soles, under the nails, in the mouth, or on the genitalia.
