Actinic Keratotoses (Pre-Cancers)

Acnitic keratoses

Have you ever been to the dermatology clinic and had “pre-cancers” frozen?  Do you know what causes these, why we treat them, or what treatment options are available?  I will be answering all of these questions and more in this most recent blog entry.

Actinic keratoses are a reflection of abnormal cell development in the skin that is most often caused by UV radiation.  This UV radiation comes mostly from the sun, but can also be found in tanning beds.  Other factors that play a role in the development of these pre-cancers include medications that make a person more sun sensitive or patients who have a compromised immune systems.  Compromised immune systems can be caused by medications or diseases like HIV/AIDs.

There are a wide range of appearances that an actinic keratosis can have.  The majority are flat to slightly raised, red areas that have an associated white to yellow scale.  Less common variants may have a thickened “horn” that arises from the growth or have some brown to black pigment found within.

The risk of one actinic keratosis turning into a skin cancer (most often a squamous cell carcinoma) is relatively low, however, most patients have multiple.  Patients that have ten or more actinic keratoses have been shown to have a 10-15% chance of developing a squamous cell carcinoma if they are left untreated.  It is the cumulative risk of many actinic keratoses that cause this increased risk.

When you come in for a skin check, your provider will evaluate your skin and decide if you have any actinic keratoses.  There are multiple ways that they can be treated.  Many actinic keratoses can be effectively treated with cryotherapy.  Cryotherapy uses liquid nitrogen to freeze and destroy these abnormal cells.  When the skin heals, smooth, normal skin will return to the area.  When patients have many actinic keratoses on their face, ears, scalp, or arms, other options may be discussed.  Field therapy is a highly effective method to treat a larger surface area of sun damaged skin.  Field therapy can be done with creams used at home or an in office light based treatment called photodynamic therapy (PDT).  Your provider will decide on the best treatment for you.

There are ways that you can help to prevent actinic keratoses.  You cannot change the sun exposure you have gotten in the past, however, you can change your risk for the future.  Wearing a daily sunscreen to your sun exposed areas is very important.  It should be SPF 30+ and include either zinc oxide or titanium dioxide.  Avoiding activities outside between the hours of 10am and 4pm when the sun is most intense is also a good habit.  Many clothing stores are now carrying SPF rated clothing as well.  This can be very helpful in protecting your skin.

If you are worried about your skin cancer or pre-cancer risk, call our office and make an appointment with one of our excellent dermatology providers for a skin check.  We would be happy to be a trusted part of your health care.


Bentonville:  701 NW McNelly Rd., Bentonville, AR 72712 (479-268-3555)

Fayetteville:  1444 E Stearns St., Fayetteville, AR 72703 (479-718-7546)

Harrison:  520 N Pine St., Harrison, AR 72601 (870-204-5279)

Ryan Crowder, MPAS, PA-C

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