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
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
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
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
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.
American Academy of Dermatology, Guidelines of Care for Actinic
Schwartz RA, et al. Epithelial
precancerous lesions. In: Freedberg IM, et al (Eds.)
Fitzpatrick’s Dermatology in General Medicine, 5th ed.,
New York: McGraw-Hill; 1999:823-39.
content solely developed by the American Academy of Dermatology
Prevention and education are an integral part of the
care of any patient with actinic keratoses.
Examples of prevention and education include, but are
not limited to, sun avoidance, protective clothing,
sunscreen protection, and self-examination.
Guidelines of Care for
Actinic Keratoses, American Academy of Dermatology