Actinic Keratosis: Those Scaly Skin Patches

Meet George. He is 55-years old and really enjoys his time in the sun. George came to the office complaining about scaly discolored areas of skin on his face—each less than an inch across. George also pointed to a slightly discolored rash on his skin that showed some redness and puffiness and generally looked irritated.

Photo. Actinic keratosis shown on the forehead.

George has what is called diffuse actinic keratosis on his face.

Here’s what we know.

Actinic keratosis is a crusty, scaly growth caused by damage from too much exposure to ultraviolet (UV) radiation. It usually affects older adults. Its appearance is a clear biologic signal of too much exposure to sun over the years.

In addition to the face, actinic keratosis can appear on other skin surfaces. These include lips, ears, back of hands, scalp, forearms, and neck. Further examination of George reveals patches on his forehead, as shown in the photo.

Skin damage due to actinic keratosis may take years to develop; and over time, these rough, scaly skin patch become enlarged. Generally, there are no other signs or symptoms. However, it is important not to ignore them because basal cell carcinoma and melanoma can develop.

What to do.

If you see changes in your skin that are bothersome and may be growing over time, make an appointment with a qualified dermatologist as soon as you notice new or changing patches on your skin. The providers at Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D., will perform a thorough skin exam and recommend treatment.

Many topical treatments are available, including 5-flourouracil, Aldara® Cream, Picato® Gel, liquid nitrogen, and photodynamic (“blue-light”) therapy. The best one for you will depend on different factors, including:

• Severity/extent of the clinical presentation
• Downtime and tolerability
• Logistics
• Cost

For a consultation and more information, contact Aesthetic Dermatology and Skin Cancer: Jeffrey H. Binstock, M.D. Dr. Binstock and Physician Assistant Stephanie Cullinane will answer your questions. Call our office in Mill Valley (415) 383-5475.