Expert Advice on Detection & Prevention of Actinic Keratosis & Squamous Cell Carcinoma
We’re back with another Derm Deep Dive, a series that provides expert advice from our team about common skin conditions or treatments. May is Skin Cancer Awareness Month, a perfect opportunity to educate about skin lesions and how to detect and treat these critical signs of skin cancer before they progress.
Spot the Signs Early
Early detection is a critical element of skin cancer prevention. You may already know to look for funny-looking moles or take notice if a spot changes in color or shape, but other types of sun-related skin damage have different indicators that are important to catch early.
What is Squamous Cell Carcinoma?
SCC is the second most common type of skin cancer, often developing in the squamous cells, which are found on the skin, some organs, and the digestive tract. Areas with long-term sun exposure, such as the head, neck, hands, and forearms, are most susceptible, but squamous cell carcinoma can form on other areas of the body.
According to the Skin Cancer Foundation, 1.8 million cases of squamous cell carcinoma are diagnosed in America each year.
Signs of Squamous Cell Carcinoma:
- Areas of the skin that feel rough, red, or scaly
- Open sores, often with a raised border
- Firm, dome-shaped growths
- A wart-like growth
- A sore that develops from an old scar
Squamous cell carcinoma tends to grow slowly, but without treatment, it can grow deeper into the skin and spread to other parts of the body, becoming deadly.
What is Actinic Keratosis?
Also known as solar keratosis, this highly treatable, non-melanoma skin growth is caused by long-term exposure to UV rays from direct sunlight, tanning beds, or sunlamps.
Direct exposure to UV radiation over time damages keratinocytes (cells that make up the skin), which can put the cells into a precancerous state.
According to a 2023 assessment by the Skin Cancer Foundation, Actinic keratosis affects nearly 58 million Americans each year, and early detection and treatment are essential.
Actinic keratosis typically develops on sun-exposed areas like the face, ears, scalp, neck, hands, and forearms.
Signs of Actinic Keratosis:
- Areas of the skin that feel scaly, crusty, or rough like sandpaper.
- Pink, red, tan, brown, grey, or flesh-colored spots on the skin.
- Sensitive spots on the skin that itch, burn, sting, or are tender when touched.
- “Gritty”, irritated, or even bleeding areas on the skin that do not heal or go away.
- Rough skin patches on areas that are most commonly exposed to the sun, like the face, ears, scalp, shoulders, hands, neck, and lips.
You may notice actinic keratosis by touch rather than by sight. If you have a persistent area of rough texture, it’s best to see your dermatologist, even if there are no visual changes.
Early detection is key, as actinic keratosis can develop into squamous cell carcinoma if left untreated.
Who is at Risk of Developing Skin Lesions?
Skin cancer can affect anyone, regardless of family or personal history, but some factors contribute more to the likelihood of developing skin cancer:
- A history of prolonged, unprotected sun exposure or sunburns
- Working outside or living closer to the equator
- Fair skin that burns more easily
- Light colored hair and eyes
- Frequent tanning bed use
- Age – individuals over the age of 50 are more likely to develop some type of skin cancer
- Gender – men are more likely to develop precancerous skin lesions
- A weakened immune system, whether from medication or a health condition
- People who have had organ transplants – squamous cell carcinoma is the most common form of skin cancer to occur in transplant recipients
Both actinic keratosis and squamous cell carcinoma are highly treatable when detected early. Some treatment options include:
- Cryosurgery: The application of liquid nitrogen directly to the precancerous cells to destroy them.
- Topical Treatments: When applied for several weeks, topical creams are highly effective at treating precancerous cells.
- Photodynamic Therapy (PDT): A topical medication is applied to the affected areas and activated by light that destroys precancerous cells.
- Electrodessication and Curettage: A combination of scraping the lesion immediately followed by heat to destroy the precancerous cells. This technique is often reserved for larger precancerous lesions.
- Laser Surgery: Using intense energy in the form of light to destroy the precancerous cells.
Prevent Precancerous Skin Lesions All Year
Even if you aren’t sure that rough spot on your skin is anything to be concerned about, get it checked for peace of mind. To reduce the likelihood of developing precancerous skin lesions, practice sun protection year-round.
Here are some sun-protection tips from our expert dermatologists:
- Wear a daily sunscreen with an SPF of 30 or higher
- Apply an SPF 50 or higher for prolonged time outside in the sun, such as at the beach. Remember to reapply every two hours and after swimming!
- Limit time in the sun, especially in the middle of the day
- Wear sun-protective clothing, such as SPF shirts, pants, and hats
- Avoid tanning beds
Think of Every Month as Skin Cancer Awareness Month
While precancerous skin lesions may start small, they are signs of sun damage and a warning that you could develop skin cancer. Seeing a dermatologist as soon as you have concerns is the best way to prevent cancer growth and preserve healthy skin.
Schedule an appointment with one of our board-certified dermatologists for a full-body skin exam to check for precancerous skin lesions or other issues.
We work closely with our patients to establish the right treatment or maintenance plan and get you on a path toward healthy, cancer-free skin.
FAQs: Actinic Keratosis & Squamous Cell Carcinoma
Is actinic keratosis a type of skin cancer?
No, actinic keratosis is considered a precancerous condition. However, it can develop into squamous cell carcinoma if left untreated.
What are the early signs of squamous cell carcinoma?
Early signs include a persistent scaly patch, a firm red bump, or a sore that doesn’t heal, crusts, or bleeds.
Can actinic keratosis go away on its own?
Some AKs may temporarily fade, but they often return. Treatment is recommended to reduce the risk of progression to skin cancer.
How serious is squamous cell carcinoma?
Most cases are highly treatable when caught early, but untreated SCC can grow deeper and, in rare cases, spread to other parts of the body.
How can I prevent actinic keratosis and squamous cell carcinoma?
Daily use of broad-spectrum sunscreen, protective clothing, and regular skin checks can effectively reduce your risk.