Spots and moles on the skin should not be taken lightly. If they appear, it is advisable to undergo a dermatological examination.

After age 40, certain types of spots can indicate precancerous lesions known as actinic keratoses or solar keratoses.

How can these spots be identified, and what treatment options are available?

What Are Actinic Keratoses?

Actinic keratoses are precancerous lesions that develop on the skin due to prolonged exposure to the sun’s ultraviolet rays. Seeking treatment for these lesions is crucial. 

If dark spots appear on specific areas of the face and body, it is advisable to consult a dermatologist as actinic keratoses can be a warning sign for certain invasive skin cancers, such as squamous cell carcinoma.

Symptoms of Actinic Keratoses

Typically, actinic keratoses manifest as small, rough, red patches on the skin. They commonly appear on:

  • Face
  • Back of the hands
  • Scalp, especially in areas of receding hairline or baldness
  • Lower lip, known as actinic cheilitis

Over time, individual spots may merge and form larger patches that often flake, leading to sensations of:

  • Tingling
  • Burning
  • Itching

Desquamation (the shedding of skin from actinic keratoses) can intermittently disappear and reappear in the same area. However, it is important to note that actinic keratoses can also be asymptomatic. Therefore, closely examining the skin to check for actinic keratoses is advisable. 

Actinic Keratoses: What Causes Them?

Prolonged and continuous exposure to ultraviolet rays from the sun or tanning lamps contribute to developing actinic keratoses.

Individuals with lighter skin types, red or blond hair, and light-colored eyes are particularly susceptible to sunburn and the formation of skin cancer lesions, making them more prone to actinic keratoses. 

It is important to be extra cautious about sun protection and monitor any spots that may appear on their skin. The categories of individuals that should be extra careful include:

  • Individuals with light skin phototypes
  • Individuals engaged in outdoor work or sports activities for extended periods
  • Individuals taking immunosuppressant drugs

Regular dermatological checkups are also recommended for people at risk.

While the risk of actinic keratoses developing into invasive squamous cell carcinoma is relatively low, they should still be taken seriously as a warning sign, as 65 percent of invasive squamous cell carcinomas originate from pre-existing actinic keratoses. 

There is also a remarkable risk of developing melanoma, the most aggressive form of skin cancer, and basal cell carcinoma (basalioma), both of which are associated with sunlight exposure.

Prevention and Treatment of Actinic Keratoses

To prevent actinic keratoses and other sun-induced skin lesions, it is crucial to take preventive measures such as:

  • Use a high-protection sunscreen (SPF 50 or higher) 
  • Wear protective clothing, such as hats and sunglasses

Regarding treatment options, they depend on the extent and severity of the actinic keratoses and include: 

  • Lesion removal (for individual visible lesions) using cryotherapy, curettage, or diathermocoagulation;
  • Topical therapies (for multiple extensive lesions affecting larger areas of the skin) that may be prescribed to inhibit the growth of precancerous cells; 

Photodynamic therapy involving the application of a light-activated medication in cream on the affected area, which is then activated by visible light.