ActinicKeratosesNet Article
Sun Protection Can Help Reduce New AKs

While treatment of actinic keratoses (AKs) is usually successful, anyone who has been treated for AKs is considered to have a moderate to high risk for developing new lesions. Many patients at high risk get new lesions every year. When new AK lesions repeatedly form, the likelihood that one AK will progress to squamous cell carcinoma, a common form of skin cancer that can be deadly, increases. For this reason, patients who have recurrent AKs or AKs that never seem to clear should:

• Perform regular self-examinations of their skin, checking for any new or changing lesion

• Receive regular full body examinations from a dermatologist

Any new or changing lesion should be examined by a dermatologist. In most cases, new AK lesions and squamous cell carcinomas that arise from AKs are successfully treated. The key to successful treatment lies in early detection. Left untreated, AKs have the potential to progress to squamous cell carcinoma. Most squamous cell carcinomas that develop from AKs are low-grade cancerous tumors that can metastasize (spread) if ignored and allowed to invade deeper tissues. Even if it does not metastasize, a squamous cell carcinoma may spread and cause substantial local tissue damage if not treated early. Squamous cell carcinoma tends to be more invasive and likely to metastasize when it 1) arises on the lip or scalp or 2) is classified as an adenoid squamous cell carcinoma that is larger than 2.5 centimeters in diameter.

Sun Protection Can Help
While a patient’s risk for developing new AKs or squamous cell carcinoma may be moderate to high, sun protection can help decrease the risk. Dermatologists routinely advise their patients to practice comprehensive sun protection, which includes sun avoidance, wearing protective clothing, and daily use of a broad spectrum sunscreen with a Sun Protection Factor (SPF) of 30 or more. The American Academy of Dermatology recommends following these sun-protection practices:

• Avoid deliberate tanning. Ultraviolet light from the sun and tanning beds causes skin cancer and wrinkling. If you want to look like you’ve been in the sun, consider using a sunless self-tanning product. When using a self-tanning product, you should continue to use sunscreen.

• Get vitamin D safely through a healthy diet that includes vitamin supplements. Don’t seek the sun.

• Generously apply sunscreen to all exposed skin. Before going outdoors, generously apply a sunscreen that has a Sun Protection Factor (SPF) of at least 30 and is broad-spectrum — protects against both ultraviolet (UVA) and ultraviolet B (UVB) rays. While outdoors, re-apply the sunscreen approximately every two hours, even on cloudy days, and after swimming or perspiring.

• Cover up when you must be in the sun. Wear long sleeves, pants, a wide-brimmed hat, and sunglasses that protect against both UVA and UVB rays.

• Use extra caution near water, snow, and sand. These reflect the damaging rays of the sun, which can increase your chance of sunburn.

Additionally, some medications may be helpful in preventing new AKs. Topical tretinoin (a vitamin A derivative used as a treatment for aging skin) has been shown to reduce the onset of new AK lesions. Topical tretinoin is a prescription medication that may not be suitable for everyone. A dermatologist should be consulted regarding the use of tretinoin and other topical retinoids.

References:
American Academy of Dermatology, Guidelines of Care for Actinic Keratoses

Schwartz RA, et al. Epithelial precancerous lesions. In: Freedberg IM, et al (Eds.) Fitzpatrick’s Dermatology in General Medicine, 5^th ed., New York: McGraw-Hill; 1999:823-39.

All content solely developed by the American Academy of Dermatology