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If you’ve spent a lot of time outside under the sun, you’ll probably start to notice brown spots appearing on your hands and arms as you get older. Sometimes called sun spots or age spots, the correct term for this condition is actinic keratosis. The spots themselves are called actinic keratoses.
Actinic keratosis (AK) is a very common skin condition. It occurs when skin cells called keratinocytes start to grow abnormally, forming scaly discolored spots. The skin patches may be brown, tan, grey, or pink. They tend to appear on the parts of the body that get the most sun exposure such as the hands, arms, face, scalp, and neck.
AK may actually be in situ stage squamous cell carcinoma (SCC) lesions. “In situ” means the lesions are confined to one location and not invading other tissue. In most cases, AK lesions are relatively benign. However, each lesion has about a 10 percent chance of progressing into an invasive form of SCC. Because of this risk, the spots should be monitored regularly for any suspicious changes.
Actinic keratosis is primarily caused by long-term exposure to sunlight. People with the highest risk of developing AK generally:
Other people at high risk for AK include albinos and organ transplant recipients who are taking immunosuppressant drugs
Actinic keratoses start out as thick, scaly, crusty skin patches. These patches are generally about the diameter of a pencil eraser. Over time, the lesions may disappear, remain the same, or develop into SCC. There is no way of predicting which lesions may turn cancerous. If you notice any of the following changes in an age spot, you should have it examined by a dermatologist:
If there are cancerous changes, don’t panic. This type of skin cancer is relatively easy to diagnose and treat in its early stages. Squamous cell skin cancer is the second most common type of human cancer. Over 250,000 new cases are diagnosed each year in the United States.
Most actinic keratoses can be diagnosed by eye. Your dermatologist may want to take a skin biopsy of any lesions that look suspicious. The only sure way to tell if an AK has changed into squamous cell carcinoma is with a skin biopsy.
There are six main strategies for treating actinic keratoses.
Reducing exposure to sunlight is the best way to prevent new actinic keratoses. It also minimizes the risk of skin cancer. Remember to:
If you have AK, you should see a dermatologist regularly. They can monitor your skin for signs of SSC. When caught early, SSC is very treatable. So don’t put off seeing your dermatologist if you have any worrisome spots!
Written by: Janet Barwell and Elizabeth Boskey, PhD
Published on: Jul 16, 2012
Medically reviewed on: Sep 07, 2017: Justin Choi, MD
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