Actinic Keratoses – Causes, Symptoms, and Treatment

Actinic keratoses are cellular changes in the outermost layers of the skin caused by chronic UV radiation. They primarily develop on areas of skin that have been regularly exposed to the sun over many years.

Typical areas include:

• Forehead
• Nose
• Cheeks
• Ears
• Scalp (without hair)
• Back of the hand
• Forearms

The skin changes often appear as small, reddened, skin-colored, or brownish areas with a rough surface. Many patients describe the sensation as if the skin feels like fine sandpaper.

Some areas are barely visible and can initially only be felt. Others appear significantly thickened or more calloused.

The primary cause is long-term exposure of the skin to UV radiation. UV rays damage the genetic material of skin cells. Over many years, this damage accumulates and can lead to pathological cellular changes.

People with fair skin, light-colored eyes, and blond or red hair have less natural UV protection and are therefore at a significantly higher risk.

People who spend a lot of time outdoors, whether for work or leisure, are more at risk. This includes, for example, tradespeople, gardeners and landscapers, or people who are physically active and have significant sun exposure.

Actinic keratoses usually appear starting in middle age, as UV damage accumulates over decades. A weakened immune system can also contribute to their development.

Actinic keratoses usually develop slowly. Typical characteristics include:

• rough, dry, or scaly patches of skin
• mild redness
• hardened or crusty areas
• occasional itching or burning

Many people first notice the rough texture of the skin before any visible changes appear.

If a lesion grows significantly, bleeds, becomes painful, or hardens further, it should be examined by a dermatologist as soon as possible, as this may indicate progression of the condition.

Actinic keratoses are not just a cosmetic problem. They represent a medically significant precursor to skin cancer.

Some of these lesions can develop into squamous cell carcinoma over time. This type of cancer is classified as a “non-melanoma” skin cancer.

For this reason, dermatologists generally recommend early and consistent treatment.

Key goals of treatment are:

• Removal of the abnormal skin cells
• Prevention of cancer development
• Treating other invisible UV damage in the surrounding area

In addition, regular dermatological checkups are important for detecting new changes at an early stage.

The most appropriate treatment depends on several factors:

• Number of lesions
• Size of the affected areas
• Location
• The patient’s skin type

Often, several methods are combined.

Freezing with liquid nitrogen selectively destroys abnormal skin cells. This method is particularly suitable for isolated, clearly defined lesions.

Certain active ingredients can be applied directly to the skin. They destroy abnormal cells or activate the body’s own immune system to fight these cells.

In this method, a light-sensitive substance is first applied to the skin. The area is then treated with a special light. This selectively destroys damaged cells.

This therapy is particularly well-suited for larger or multiple actinic keratoses.

Lasers can precisely ablate superficial layers of the skin and are primarily used for certain extensive lesions.

The most important protection against actinic keratoses is consistent protection from UV radiation.

This includes:

• Sunscreen with a high SPF
• protective clothing and head coverings
• Avoiding intense midday sun
• Avoiding tanning beds

Anyone who already has skin that has been heavily exposed to the sun should also have regular skin checkups with a dermatologist.

Actinic keratosis is a skin lesion caused by UV radiation that has a rough, scaly surface. It is considered a possible precursor to non-melanoma skin cancer.

Typical signs include small, rough, or scaly patches that often feel like sandpaper. They frequently appear on the face, scalp, or backs of the hands.

They are usually easy to treat initially, but should be taken seriously. Some of these lesions can develop into skin cancer.

Some lesions may appear less noticeable for a time. However, they often persist or recur. A dermatological examination is therefore important.

Depending on the findings, cryotherapy, medicated creams, photodynamic therapy, or laser treatments may be considered. The choice of treatment is determined on an individual basis by the dermatologist.

Daily sun protection, avoiding UV exposure, and regular skin cancer screenings are crucial.

Actinic keratoses are common skin lesions caused by long-term UV exposure. They should not be underestimated, as they are considered a precursor to non-melanoma skin cancer.

Early diagnosis and consistent dermatological treatment can prevent these lesions from developing into skin cancer.

People who have their skin checked regularly and consistently use sun protection can significantly reduce their personal risk.