Is it AK or OK?

Ask your doctor.

Millions of people have actinic keratosis. Doctors commonly treat this condition, but few people know how to spot it or that it can lead to skin cancer.

Actinic keratosis, or AK, is a visible sign of sun damage caused by prolonged sun exposure. AK is considered a “precancer,” or a first step in developing skin cancer. AKs are small, red, sometimes scaly or rough spots that can be found on skin most often exposed to the sun like the face, bald scalp, hands, shoulders, and arms. Some AKs will develop into a serious form of skin cancer called squamous cell carcinoma, or SCC. If left unchecked, this cancer can spread to other areas of your body and organs. Because you cannot predict whether an AK will develop into cancer, it is important to check any changes in your skin with a doctor.

Early detection is key to successful treatment of AK. So is knowledge. To stay healthy, see your doctor each year for a skin check-up and visit our Web site for helpful updates.

“Is it AK or OK?” is an educational program sponsored by Graceway Pharmaceuticals in partnership with the Skin Cancer Foundation.

What is AK?

AK is an early warning sign.

• Are you fair-skinned?
• Are you age 40 or older?
• Have you spent long periods of time outdoors?
• Are you male?
• Do you live in a sunny place like California or Florida?

If you answered “yes” to any of these questions, read further to learn more.

For many years, it was believed that the majority of sun damage occurs before adulthood; however, with increasing numbers of people engaging in outdoor recreation for longer periods of their lives, recent research has shown that sun damage accumulates well into late adulthood. Just as you may fondly remember carefree summers, so does your skin—it too has a memory. Over time, the effects of the sun’s harmful rays accumulate under the skin. These rays cause changes in the size, shape, and organization of the top layer of skin cells, also known as the epidermis, and just below it. These cellular mutations then can form AKs.

AKs can vary in shape and color, ranging from red to light or dark tan, pink, or a combination of these. They generally reach a size of an eighth to a quarter of an inch. An AK may feel dry and rough like sandpaper. In the beginning, AKs can be so small that you’re more likely to spot them by their rough feel than by sight.

If you have one AK, you’ll likely develop more over your lifetime. Also, for every AK you can see, there can be many invisible AKs under your skin’s surface, which are referred to as sub-clinical AKs.

If you see anything suspicious, schedule a check-up with a dermatologist.

How to spot AK

It's not a mole. AK is different.

AK is most commonly found on skin that’s frequently exposed to the sun. So you’ll want to start your search on body parts such as the bald scalp, face, ears, lips, backs of the hands and forearms, shoulders, and neck

Look for rough or scaly patches on the skin. Remember to feel the skin first, as AKs can be very small but are often identifiable by their rough surface. Also take notice of any skin that looks discolored, ranging from red to light or dark tan, pink, or a combination of these. While most AKs are dry, rough patches, they may also look like:

• Eczema or psoriasis
• Reddish, crusty raised skin
• Age spots with irregular borders
• Red irritated growths with yellow scales or sores that do not heal
• Smooth, round, raised lesions
• Thick horns that are raised from the surface of the skin

Remember, AKs are precancers. Don't wait to contact your doctor or dermatologist to check any suspicious spots on your skin.

How to treat AK

If you have AK, you have options.

To treat AK, it is recommended that you see a dermatologist. A quick skin examination is usually all it takes to diagnose the condition. Since you cannot be sure if an AK will develop into skin cancer, it is important to get it treated. Also, your doctor may recommend a biopsy, which involves taking a small sample and testing it.

The good news is that you have options to safely and effectively treat AK. The number of AKs you have and their location may affect your treatment choice. If you develop an AK on a visible area like the face or scalp, you may be concerned about what it looks like. Your dermatologist can advise you on the best treatment. Your dermatologist may use one or a combination of the following treatments to treat AK.

Topical Creams

Cryosurgery

Surgical Excision

Chemical Peel

Curettage & Electrosurgery

Photodynamic Treatment

Laser Therapy

For more information on your options, visit the Skin Cancer Foundation’s site at www.skincancer.org.

Facts about AK

Face the facts.

• AK is the most common precancer.
• It’s estimated that more than 10 million Americans have AKs.
• Since men tend to spend more time in the sun and use less sun protection than women, they are more likely to develop AKs.
• 10%-15% of patients with 10 or more AKs may develop a skin cancer called squamous cell carcinoma.
• Men are at least twice as likely as women to develop squamous cell carcinomas
• 40%-60% of squamous cell carcinomas (a form of skin cancer) begin as untreated AKs.
• AKs most often appear on the bald scalp, face, ears, lips, backs of the hands and forearms, shoulders, neck, or any other areas of the body frequently exposed to the sun.
• In the beginning, AKs are frequently so small that they are recognized by touch rather than sight. They also sometimes start as invisible lesions that cannot be seen on the skin surface.
• Once an AK is identified, a variety of treatment options are available. These include physically removing the AK by freezing it with liquid nitrogen, burning it with a laser, scraping it off, or using chemicals that kill the AK cells.
• A number of noninvasive creams that can be applied to the skin are also available for the treatment of AK.