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What you need to know about actinic keratosis

The sun is shining, summer’s here and you’re probably already spending more time outside than in. You already know you need to protect yourself from the sun (no tanning, please) but it’s also important to be proactive when it comes to knowing how overexposure to the sun can affect your skin. For instance, actinic keratosis (AK) – also referred to as sun spots – is an often-overlooked form of pre-cancer, affecting more than 10 million Americans. AK is worth knowing more about because it has the potential to progress to squamous cell carcinoma (SCC), the second most common skin cancer.

Woman looking at sun spot

Expert advice

We turned to Dr. Thomas W. Bender III, board-certified dermatologist and owner of Gulf Coast Dermatology and Skin Care Centre in Mobile, Alabama, for some insight into actinic keratosis and what you need to know about it.

AK explained

AKs are rough-textured, dry, scaly patches on the skin caused by excessive exposure to ultraviolet light, Bender explains. They occur most often on the face, scalp, ears, neck, hands and arms and can range in color from skin-toned to reddish-brown. They can also range from roughly the size of a pinhead to larger than a quarter. There are various treatment options you can discuss with a dermatologist. “The problem with sun spots is the general public will have a hard time distinguishing these from other skin problems. A professional is needed to identify and treat all skin cancers or pre-cancers,” the dermatologist says.

What you need to know

Your first line of defense against AK is sunscreen. “Sunscreen will help protect against the darkening of these spots and the development of new ones,” Bender says. When it comes to choosing the best sun protection option, he advises going with a physical blocker such as zinc oxide or titanium dioxide, which provides a broad spectrum of protection and isn’t irritating. He also advises seeing a dermatologist to have a thorough skin exam to make sure any spots or markings you do have are harmless, as opposed to some other sort of skin lesion with the potential to develop into something more serious. “Not all sun spots will become cancerous and it is best to seek a professional opinion to determine if something is benign, precancerous or cancerous,” he says.

When to get checked out

While most AKs remain benign, approximately 10 percent develop into SCC within an average of two years, Bender explains. Seeing your dermatologist early and often is key, but there are also some signs to be aware of. Three things you need to look for are:

  1. Irregular borders
  2. A variation in color
  3. Spots larger than 6mm in size

These are indications that the skin growth should be examined by a board-certified dermatologist. You should also see a dermatologist if you have a spot that just looks different from everything else on your skin, a sign Bender says is often referred to as the “ugly duckling” sign. As for what can be done about AK, your dermatologist will discuss the best options for you. “When you see your dermatologist and sun spots are diagnosed, you can get rid of them in a variety of ways, including laser treatment, photodynamic therapy, chemical peels and other topical preparations,” he says.

Avoid these skin slip-ups

Since avoiding overexposure to the sun is the best way to avoid AK and other sun-related skin problems, it’s important to ensure you’re always being sun-smart. Bender says the first mistake people make with their skin is not protecting it properly, so always remember to apply sunscreen, even on cloudy days. “The importance of sunscreens that have a physical blocker can’t be overstated,” he adds.

He also recommends wearing sun-protective clothing and trying to avoid long-term sun exposure when UV radiation is at its peak (between 10 a.m. and 4 p.m.) 

The second mistake people often make is assuming that all spots are simply cosmetic in nature, so instead of going to a dermatologist they try to treat their spots with over-the-counter products. This is never a good idea and can often delay a diagnosis of a more significant condition, Bender warns. Check your skin regularly and see your dermatologist if you notice anything irregular. You can never be too careful when it comes to your health.

More sun care advice

Summer skin health: Skin cancer awareness
Skin cancer: 5 warning signs
Skin cancer: How to protect your skin

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