Actinic and Seborrheic Keratoses

Actinic keratoses (AKs)

Actinic keratoses (AKs) are one of the most common reasons that people see dermatologists. They are growths on your skin that usually feel rough, like sandpaper. Also called “solar keratoses,” AKs are precancerous, meaning that they often progress to skin cancer if left untreated. AKs are caused by damage from UV light- either by sun exposure, or using a tanning bed or sun lamp.

AKs usually appear as dry, scaly, and rough growths. Color varies from skin-colored (which usually feel rough like sandpaper), to red, brown, or a yellowish-black. AKs also vary in size. Sometimes AKs even grow upward and resemble a horn. This is called a cutaneous horn, and it usually appears on ears, especially in men. In general, AKs can form anywhere on the body, but especially on areas of the body the get the most sun- face, scalp (especially a bald scalp), ears, neck, chest, back, arms, and hands.

Fair-skinned people, people over 40, and people who’ve had a lot of sun exposure are at higher risk for getting AKs. Contact our office for an exam if you have a growth on your skin that begins to itch or bleed, becomes noticeably thicker, changes in size, shape, or color, or comes back after treatment.

There are many treatments available for AKs. If our providers find AKs at your body exam, they may take different approaches. The recommended treatment(s) for AKs will be based on many factors, including your health and medical history, how many AKs they are treating, and the sizes and locations of your AKs. Some treatments for AKs include: curettage and electrodesiccation, TCA chemical peel, photodynamic therapy (PDT or Blu-U), cryosurgery (“burning” or “freezing” growths), or a prescription medicine.

The best prevention for AKs is avoidance of UV light. Wear sun-protective clothing and a physical block sunscreen with SPF 30 or higher. Always reapply sunscreen every 2 hours when you’re outside, even on cloudy days. Avoid use of tanning beds, which can emit stronger UV rays than the sun.

Seborrheic keratoses (SKs)

AKs are sometimes mistaken by patients as SKs. Seborrheic keratoses (SKs) aren’t usually as flat or rough, as AKs. SKs are common non-cancerous skin growths that are usually associated with aging. SKs are also mistaken for warts or moles often, including melanoma.

SKs range in color from tan to black, and vary in size. They usually begin as a small bump on the skin, which grows and thickens slowly. The way to distinguish an SK is that they have a dull, waxy appearance, and look like they’ve been “stuck on” the skin. Since SKs can become very dark and irregular in shape, resembling melanoma, it is important to watch for changes, itching, or bleeding in any growth.

It is not known what causes SKs, but they tend to run in families, and may be a result of hormone changes.

SKs are benign, non-cancerous, growths, so treatment is not generally considered medically-necessary by insurance companies, so most dermatologists treat SKs as a cosmetic procedure. However, there are reasons beyond cosmetic reasons that you may want to treat your SKs. For example, if you have large SKs or they are easily irritated by clothing or activity, you may want to treat your SKs.

There are multiple treatment options available in our office for SKs. Our providers will lay out those options for you before you decide if treatment is right for you. Although SK treatments are cosmetic, you should always seek dermatologic care if they are itchy or bleed, as that could be a sign of a more serious problem.