Actinic keratoses
Actinic keratoses are widespread, sun-induced skin changes that are considered a precursor to non-melanoma skin cancer. Because they can develop unnoticed over years, early diagnosis is crucial to prevent potential malignant transformation.
At the Decamed Skin and Laser Center, we offer modern, highly effective therapies that are individually tailored to your skin condition.
Table of Contents
- What are actinic keratoses?
- Causes & Risk Factors
- Symptoms & typical locations
- Risk of developing skin cancer
- Diagnostics at the dermatologist
- Treatment options
- Treatment procedure
- Aftercare & Prevention
- Frequently Asked Questions (FAQ)
1. What are actinic keratoses?
Actinic keratoses are rough, scaly, or reddish areas of skin caused by long-term UV radiation. They occur primarily on chronically sun-exposed areas of the face, hands, scalp, or décolleté.
Since they represent a precancerous condition, i.e., a precursor to squamous cell carcinoma, they should definitely be treated professionally.
2. Causes & Risk Factors
2. Causes & Risk Factors
The most important trigger is UV light, especially over many years.
Other risk factors:
- fair skin type, light hair
- Outdoor jobs or spending a lot of time in the sun
- frequent sunburns
- Immunosuppression
- genetic factors
INFOBOX:
Over 80% of all actinic keratoses develop on skin areas that are exposed to the sun daily.
3. Symptoms & typical locations
3. Symptoms & typical locations
Actinic keratoses are often inconspicuous. Typical characteristics:
- rough, sandpaper-like surface
- reddish or brownish discolorations
- scaly, crusty patches
- slightly raised plaques
- occasional burning or itching
Frequently affected regions:
- Face
- ears
- Forehead & baldness
- cleavage
- back of hand
- forearms
4. Risk of developing skin cancer
4. Risk of developing skin cancer
Actinic keratoses are considered an early stage of squamous cell carcinoma.
The risk of actinic keratosis developing into skin cancer is approximately 6–10% within 10 years, and correspondingly higher if there are multiple lesions.
Therefore, early treatment is important to protect the skin in the long term.
5. Diagnostics at the dermatologist
5. Diagnostics at the dermatologist
Clinical examination
The diagnosis is usually made simply by visual inspection.
Dermoscopy
The reflected light microscope can be used to assess structural changes and pigment patterns.
Biopsy (rarely necessary)
Only in cases of unclear or already suspicious lesions.
6. Treatment options
6. Treatment options
Depending on the number, extent and skin type, we choose the appropriate form of therapy:
1. Cream therapy (e.g. fluorouracil, imiquimod)
- targeted treatment of single or multiple lesions
- activates the immune system
- leads to a controlled inflammatory response
2. Photodynamic therapy (PDT)
- especially suitable for areas of infestation
- highly effective against actinic keratoses
- very good cosmetic result
3. Cryotherapy (freezing)
- quick, easy treatment of individual areas
- less precise in cases of widespread infestation
4. Laser treatment
- precise material removal
- smoother skin appearance
- often combined with PDT
INFOBOX – Advantages of modern therapies:
Thanks to minimally invasive procedures, actinic keratoses can be treated effectively, often with visible improvement in the skin's appearance.
7. Treatment procedure
7. Treatment procedure
- Initial examination & diagnostics
- Determining the correct therapy (cream, PDT, laser, cryo)
- Treatment in 1-2 appointments
- Check-up after a few weeks
- Repeat if necessary for severely sun-damaged skin.
The following often occur after treatment:
- Redness
- Crusts
- swelling
This is desired and temporary.
8. Aftercare & Prevention
8. Aftercare & Prevention
- Consistent sun protection (SPF 50)
- Avoid the midday sun
- regular skin checks
- early treatment of new lesions
Especially important for patients with:
- many keratoses
- immunodeficiency
- strong UV history
9. FAQ – Frequently Asked Questions
9. FAQ – Frequently Asked Questions
Are actinic keratoses dangerous?
They are a precursor to skin cancer and therefore require treatment.
Does the treatment hurt?
Creams and PDT can cause burning, cryotherapy can cause a brief stinging sensation, but all are well tolerated.
Can actinic keratoses recur?
Yes, especially for severely UV-damaged skin → regular check-ups are important.
Can I remove them myself?
No, the risk of worsening the condition is too high.
Conclusion
Conclusion
Actinic keratoses are early signs of chronic sun damage and can develop into skin cancer. Modern therapies such as photodynamic therapy (PDT), lasers, or creams now offer very effective and gentle treatment. Consistent follow-up care protects your skin in the long term and prevents new changes.