An actinic keratosis (AK) is also called a solar keratosis. It refers to a scaly, crusty growth that occurs due to damage from ultraviolet (UV) radiation exposure. The term “keratoses” is commonly used as it rarely occurs as just one.

If left untreated, AK may develop into skin cancer. It usually develops into squamous cell carcinoma (SCC) which is the second most common form of the disease. Over 419,000 cases of skin cancer in the US annually are connected to indoor tanning.

Common Sites of AK

AK is the most commonly occurring precancerous skin lesion on skin that has undergone frequent sun or UV radiation exposure (such as tanning beds). Rarely, AK may develop due to extensive x-ray exposure. They typically appear on sun-exposed sites such as the bald scalp, face, shoulders, ears, neck and the back of the forearms and hands.

They may also develop on the shins and other areas of the legs. AKs are usually raised, rough, and appear similar to warts. They are commonly red, but some are white, light or dark tan, pink and/or flesh-hued, or a combination of these hues.

Appearance of AK

At the outset, AKs are typically so tiny that they can only be felt rather than seen. It feels similar to running a finger over sandpaper. In fact, the patient may have many more subclinical (invisible) lesions than those appearing on the skin’s surface.  

AKs most often form gradually and attain a size ranging from an eighth to a quarter of an inch. They may also disappear early on and reappear later. Sometimes they cause itching, or a pricking or a tender feeling. They may become swollen and surrounded by redness, and rarely, even bleed.

Why should you be concerned about AK?

Most AKs remain noncancerous, but they reveal that the patient may have experienced sun damage and is at-risk for the development of skin cancer, specifically SCC. The presence of one AK may lead to the development of more.

AKs left untreated, and those that are older have a higher probability of developing into an SCC. Some researchers view AK as the initial form of SCC. Rarely, AKs may develop into basal cell carcinoma (BCC) which is the most commonly occurring type of skin cancer.

Left untreated, SCC may become invasive and dangerous. Actinic cheilitis is a variant of AK which is usually an aggressive form of pre-cancer on the lower lips. It has a higher risk of developing into an invasive SCC.

After cancer due to actinic cheilitis penetrates the outer lip skin (mucosa, mucous membranes), it can cause bleeding, become infected, develop into a sore that does not heal, and even spread to internal organs.

Around 10 percent of AKs develop into cancers. Most SCCs start as AKs, but there is no method to determine which ones may develop into SCC. There are, fortunately, various effective treatments for removing AKs.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

Actinic Keratoses (AK) may occur due to a number of causes. The skin care specialist will discuss the possible causes and advise appropriate dermatology treatment to a patient.

Suncoast Skin Solutions, led by dedicated board certified dermatologist Dr. Christopher Ewanowski, provides advanced skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winterhaven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding communities in the illustrious Sunshine State.

Sun Exposure – A Key Cause

Almost all actinic keratoses (AKs) occur due to chronic sun exposure. The sun damage that the skin sustains is cumulative. Therefore, even short periods of sun exposure add up over a lifetime.

Around 70 to 80 percent of ultraviolet (UV) radiation can penetrate through clouds making even cloudy days unsafe. These destructive rays can reflect off snow, sand, and other surfaces creating extra exposure.

The amount of time spent in the sun over the years increases the chances of AK development. This is why outdoor workers and the elderly face a higher risk. AK development is slightly higher in males as they tend to spend more time in the sun and do not use sun protection as much as women do.

While AKs do occur in some people in their 20s as well, they develop more often in people aged over 50. Some experts state that almost everybody above the age of 80 has AKs.

The proximity of a person to the equator increases their likelihood of developing AKs.

Other Causes

The UV rays emitted by the lights in a tanning salon may be even more harmful than those given off by the sun. Therefore, dermatologists advise against indoor tanning. Tanning increases the risk of developing AKs. Sometimes AKs may also occur due to significant exposure to x-rays or various industrial chemicals.

Who is at the highest risk?

The people that are most at-risk for sun damage are those with fair skin, freckles, red or blonde hair, and green, blue, or gray eyes. They have a higher possibility of AK development in they spend extended periods in the sun and live long enough for the damage to manifest as AKs.

While Hispanics, African Americans, Asians and other ethnicities with darker skin tones are not as vulnerable to AKs as Caucasians, anyone can be affected by skin cancer.

The late detection of skin cancers in many African Americans and Hispanics results in these cancers being treated at more advanced stages in comparison to Caucasians.

People who have a weakened immune system due to AIDS, organ transplantation, chemotherapy, or other reasons are less able to respond to the harmful effects of UV rays and are much more likely to develop AKs. It is also important to note that long-term UV exposure also weakens the immune system and reduces its ability to address UV damage.

Why you should be concerned?

While most AKs remain benign, they indicate that a person has sustained sun damage and can potentially develop any form of skin cancer, particularly the second most common type of the disease, squamous cell carcinoma (SCC).

A person with one AK may develop more. The chances of AKs developing into SCC depend on the number of untreated AKs and the older they are. Some researchers believe that AK is the initial form of SCC. Rarely, AKs may develop in basal cell carcinoma which is the most commonly occurring type of skin cancer.

Dr. Ewanowski’s skin care clinic receives patients from Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winterhaven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and nearby areas.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

Timely dermatology treatment can prevent almost all actinic keratoses (AK) from becoming skin cancers.

In case the physician suspects an AK to be early cancer, they may take a tissue sample for biopsy by trimming off a portion of the AK with a scalpel or scraping the lesion with a curette (an instrument that has a sharp ring-shaped tip).

The doctor may also use the curette to shave off the base of the lesion. They may use an electrocautery needle or apply trichloroacetic acid (TCA) to stop the bleeding. This procedure will be done with the patient under local anesthesia.

The accomplished Suncoast Skin Solutions, led by compassionate board certified dermatologist Dr. Christopher Ewanowski, provides advanced skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding locations.

Treatment Options

The nature of the growth of actinic keratoses, as well as the patient’s age and medical condition, will determine the treatment. Basic treatment options include:

Surgical Procedure

The following surgical procedures are most commonly used to treat AK:

Cryosurgery

In this procedure, the physician will apply liquid nitrogen to the AK in order to freeze the tissue. Subsequently, the lesion and the frozen skin around it may blister or become crusted and fall off.

Curettage and Desiccation

The doctor will scrape or shave off a portion of the entire lesion. They will then apply heat or a chemical agent to control the bleeding as well as potentially eliminate any remaining AK cells.

Laser Surgery

In this procedure, the doctor uses intense light to vaporize the AK tissue.

Topical Treatments

In case the patient has multiple or widespread AK, the doctor may prescribe a topical gel, solution, or cream. These can address visible and non-visible lesions will minimal scarring risks. This type of treatment is also known as “field therapy” as the topical treatments can cover a wider field of skin in comparison to targeted individual lesions.

• 5-fluorouracil (Carac, Efudex, Fluoroplex): This is a type of topical chemotherapy.
• Chemical peel: This treatment is best known for mitigating signs of photoaging. However, it is also effective in the removal of certain superficial facial AK, especially when other techniques have proven ineffective. The doctor will apply trichloroacetic acid and/or similar chemicals to the face which will exfoliate the superficial skin layer.
• Diclofenac (Solaraze) and hyaluronic acid: This treatment involves a combination of topical therapy.
• Imiquimod (Aldara, Zyclara): This treatment is a type of topical immunotherapy which prompts the immune system to generate interferon. This chemical attacks cancerous and precancerous cells.
• Ingenol mebutate (Picato): This is a fast-acting topical therapy derived from plants.

Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) is particularly effective on widespread facial and scalp lesions. The physician will apply a light-sensitizing topical agent to the lesions and then use a powerful light to activate the light. This destroys the AK allowing the normal tissue to remain unharmed.

After applying the light-sensitizing agent, some doctors prefer to expose it to sunlight rather than artificial light. This is called daylight PDT, and it is believed to be a more gentle treatment in comparison to standard PDT.

Combination Therapy

Sometimes doctors may combine therapies to treat AK. In general, the treatment regimens are a combination of cryosurgery with PDT or a topical agent such as diclofenac, imiquimod, 5-fluorouracil (5-FU), or ingenol mebutate.

The doctor may also prescribe the topical meds and PDT alternately every three months, six months or one year, depending on the follow-up skin exams.

It is crucial to note that some of these treatments increase sensitivity to sunlight. Therefore, the patient should check with their physician and become especially proactive about using sun protection during the treatment period.

The skin care clinic of Dr. Ewanowski is equipped to provide cutting edge treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and nearby areas.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

A number of advanced dermatology screening tests are available today to diagnose skin cancers. Following a confirmed diagnosis, the treatment provider may recommend Mohs surgery to address the condition.

Suncoast Skin Solutions, led by board certified dermatologist Dr. Christopher Ewanowski, provides poignant, accepted, and sagacious skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brookesville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding locations across this landscape.

Skin Cancer Screening – Key Points

• Various tests are used to screen different types of cancer.
• Undergoing a skin examination for skin cancer screening has not been proven to reduce a patient’s probability of dying of skin cancer.
• Clinical trials are evaluating other screening tests.

Tests are Used in the Screening of Different Types of Cancer

Certain screening tests are used as they have been proven to be effective in detecting cancers in their early stages and in reducing the possibility of a person dying from these cancers.

Others tests are used due to their proven ability to detect cancer in some people. But clinical trials outcomes have not indicated that these tests will reduce the risk of dying from cancer. Scientists analyze screening tests to identify those with the least risks and most advantages.

Mohs Surgery

This surgery is used in the treatment of skin cancer and has some unique advantages. The surgeon can determine where the cancer stops during this surgery. With other types of treatment for skin cancer, this is not possible.

The ability to determine where the cancer stops has two vital benefits:

1. Mohs surgery has a high cure rate.
2. It enables the patient to keep as much normal skin as possible as the surgeon removes only the skin with malignant cells. This factor is vital when skin cancer forms in an area which as little underlying tissue such as the ear, eyelid, or hand.

When is Mohs surgery recommended?

A majority of Mohs patients have a common form of skin cancer such as squamous cell carcinoma (SCC) or basal cell carcinoma (BCC). This surgery is typically recommended when an SCC or BCC:

• Covers a substantial area or is aggressive
• Occurs in a site with little underlying tissue such as the nose, ear, eyelid, genitals, scalp, hand or foot.
• Has recurred after being treated previously

In addition, Mohs is also used to address certain rare skin cancers such as DFSP, extramammary Paget’s disease, and Merkel cell carcinoma.

Can Mohs treat Melanoma Effectively?

The answer is, yes. Dermatologists, at times, recommend Mohs surgery for treating melanoma which is the most serious form of skin cancer. Mohs is used to address only early melanoma, and it must be a type of melanoma known as lentigo malignant melanoma. This melanoma remains close to the skin’s surface for some time.

In the treatment of melanoma, the surgeon employs a modified Mohs surgery technique known as slow Mohs. It is referred to as slow due to the fact that the patient must wait for a longer duration for the outcomes. The surgeon cannot always view the excised skin and assess if it contains cancerous cells and more time is required.

In a slow Mohs procedure, the surgeon will excise the visible skin cancer and some margin of healthy skin surrounding it. Then the patient will be bandaged and sent home.

A majority of patients come back the next day. At this time, the patient learns if more skin must be removed or the wound can be sealed. Some wounds are left to heal by themselves.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

Actinic keratoses (AK) usually develop on the lips, face, bald scalp, ears, neck, shoulders and the back of the forearms and hands.

These may range in size from a small spot to as much as one inch in diameter. AKs commonly look like small, crusty or scaly bumps or “horns.”

The base of the AK may be light or dark skin-colored and may also have more colors such as red, pink, and tan. Actinic cheilitis, which is a variant of AK, develops on the lower lip and its symptoms may include cracks, chapping, and whitish discoloration.

Not Easy to Detect

A person should routinely examine their skin for lesions. However, it is not always easy to detect AKs as they have varied appearances. Therefore, in case an individual detects an unusual or changing growth, they should contact an expert in medical dermatology as soon as possible.

Suncoast Skin Solutions, led by kind board certified dermatologist Dr. Christopher Ewanowski, provides advanced skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winterhaven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding communities across the landscape.

What is AK?

An AK is a scaly and rough patch of skin that occurs due to long-term sun exposure. It typically develops on the ears, face, lips, scalp, neck, or the back of the forearms and hands.

AK is also known as solar keratosis, and it gradually becomes larger with typically no symptoms other than a tiny spot or a patch on the skin. It takes years for such patches to develop and they commonly first manifest in people aged above 40 years.

A small number of AK lesions can slowly develop into skin cancer. Minimizing sun exposure and protecting the skin from UV rays can decrease the risk of AK development.

Symptoms

The symptoms of AK are as follows:

• A dry, rough, or scaly patch of skin which is typically under one inch (2.5 cm) in diameter
• Flat to a marginally elevated bump or patch on the uppermost skin layer
• A wartlike, hard surface at times
• Colors ranging from pink and red to brown
• A burning or itching sensation in the impacted area

AK are typically located in areas that are exposed to sunlight such as the lips, ears, face, forearms, scalp, hands, and neck.

Common Signs to Note in Routine Self-Exam

• Numerous tan crusts and red bumps on the scalp and forehead.
• The lower lip with white patches, a protuberant sore and cracks with dried blood (this could potentially be a combination of cheilitis and skin cancer).
• Crusted red spots on the ear and cheek.
• Many silvery, red, white, and scaly lesions on the back of a finger.
• A concentrated AK area on the cheek.

When to Consult a Dermatologist

It can be hard to differentiate between benign and malignant spots. The best course is to have any new skin changes assessed by a dermatologist, especially if a lesion or spot grows, bleeds, or persists.

Early Detection and Treatment

Almost all AK can be eliminated or cleared up if treated early before they become cancerous. Some untreated AKs may become squamous cell carcinoma, which is a type of cancer that is typically not deadly if diagnosed and treated early.

The accomplished Dr. Ewanowski’s skin care clinic receives patients from Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winterhaven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and other towns and cities in this amazing area of the southeast.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

Mohs surgery is one of the most widely used and reliable surgical dermatology procedures to treat skin cancers. An experienced Mohs surgeon will explain the steps involved in the procedure to the patient at the time of initial consultation.

Suncoast Skin Solutions, led by board certified dermatologist Dr. Christopher Ewanowski, provides proven and effective skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brookesville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding communities.

Mohs Surgery for Skin Cancer – Procedure Steps

1. The location of the skin cancer will determine whether a patient will be able to wear their regular clothes or will require a hospital gown. The Mohs surgeon will evaluate the area where the patient had their biopsy and may mark it with a pen for easy reference. The doctor will position the patient for best access implying that the patient may be sitting up or lying down.

A surgical drape will cover the area. In case the skin cancer is present on the facial skin, it may mean that the patient will not be able to view what is happening.

However, the doctor will communicate with the patient throughout the procedure. Subsequently, the surgeon will inject a local anesthetic to numb the area entirely, but the patient will remain awake during the procedure.

2. The surgeon will use a scalpel to excise a thin layer of apparent cancerous tissue. Certain skin cancers may be like the “tip of an iceberg” implying that they may have extensions or roots that are invisible from the surface.

The following lab assessment will determine this aspect. A temporary bandage will be placed on the wound, and the patient can relax as the lab test commences.

3. The surgeon dissects the tissue into sections and color codes these sections using dyes. They also draw a map of the surgical area. The lab technician freezes the dissected tissue and then makes very thin horizontal slices akin to a layer of cake.

They will then place these slices on microscopic slides and stain and cover them. This is an intricate and time-consuming process.

4. The surgeon will assess all the edges and the tissue’s underside on the slides using a microscope. In case any cancer cells are visible, the surgeon will mark their location on the map and let the patient know that the removal of another skin layer will be necessary.
5. The surgeon will administer more anesthetic to the patient, if required. They will them remove another skin layer exactly where the cancer cells remain according to the map. Subsequently, the lab work will resume on the newly removed tissue. This process is repeated as many times as necessary until the malignant cells are entirely removed.
6. After the area is free of all cancerous cells, the surgeon may leave the wound open or seal it with sutures. This will depend on the location and size of the wound. In certain cases, the wound may require reconstruction via a skin graft which involves moving the surrounding tissue into the wound or performing a skin graft.

Sometimes the Mohs surgeon may coordinate the wound repair with another expert such as a plastic surgeon, hand surgeon, or oculoplastic surgeon. In general, the Mohs surgeon will repair the wound right after ensuring that the margins are clear.

7. The patient should be prepared to spend many hours for this procedure, especially if more than one or two rounds of excision are required. It is worth the time investment as this targeted procedure has the highest cure rate of any technique and can save the most amount of normal tissue while creating the tiniest scar possible.

The patient should follow the doctor’s wound care, scar care, and follow-up guidelines carefully for best results.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.

A range of skin cancer tests and dermatology treatments are available today to detect and treatment different types of skin cancers. A qualified medical professional will recommend the appropriate tests or treatments depending on the patient’s condition.

Suncoast Skin Solutions, led by kind board certified dermatologist Dr. Christopher Ewanowski, provides proven and effective skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brookesville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding communities in the majestic Sunshine State.

Imaging Tests

Imaging tests make use of magnetic fields, x-rays, or radioactive materials to develop images of the body’s inside. They are primarily employed to assess the possible spread of melanoma to the lymph nodes or other areas of the body. Individuals with early-stage melanoma will not need imaging tests as the melanoma would have likely not spread yet.

These tests can also be done to evaluate whether the treatment is effective and detect any potential signs of the cancer recurring (coming back) following the treatment.

Chest X-ray

This test can be performed to understand whether the melanoma has spread to the lungs.

Computed Tomography (CT) Scan

The CT scan employs x-rays to create a vivid, cross-sectional picture of the body. A CT scan can display the detail in soft tissues, such as internal organs, unlike a routine x-ray. It can show whether any lymph nodes are enlarged or if organs such as the lungs or liver have dubious spots which may indicate the spread of melanoma.

Magnetic Resonance Imaging (MRI) Scan

MRI scans make use of radio waves and powerful magnets rather than x-rays to develop detailed pictures of body parts. MRI scans can effectively procure images of the spinal cord and brain.

Positron Emission Tomography (PET) Scan

A PET scan can indicate whether cancer has spread to the lymph nodes or other areas of the body. For people with more advanced stages of melanoma, a PET scan is most useful. However, it is typically not done in patients with early-stage melanoma.

Skin Cancer Treatments

In addition to surgery, the following treatment options may be used to treat certain skin cancers:

Chemotherapy

Chemotherapy is a cancer treatment that makes use of medications to prevent the growth of cancer cells by either destroying the malignant cells or preventing them from dividing.

When chemotherapy is administered by mouth or injected into a muscle or vein, the drugs enter the bloodstream and reach the cancer cells in the entire body (systematic chemotherapy).

Upon placing chemotherapy directly into the cerebrospinal fluid, a body cavity such as the abdomen, or an organ, the medication primarily impacts the cancer cells in those regions (regional chemotherapy).

A type of regional chemotherapy is known as hyperthermic isolated limb perfusion. In this technique, anticancer medication is directed into the arm or leg with cancer. The blood flow to the limb is cut-off temporarily with a tourniquet.

A warm solution comprising anticancer medication is administered directly into the blood of the limb. This delivers a high medication dose precisely to the areas affected by cancer.  

Radiation Therapy

Radiation therapy refers to cancer treatment that uses powerful x-rays and other forms of radiation to destroy cancer cells and prevent them from proliferating. The two forms of radiation therapy are as follows:

• External radiation therapy utilizes a machine located outside the body to deliver radiation to cancer.
• Internal radiation therapy makes use of a radioactive material sealed in seeds, wires, catheters, or needles. These are placed directly into or near the cancer.

Immunotherapy

Immunotherapy refers to a treatment that uses the immune system of the patient’s body to battle cancer. Substances produced by the body or developed in a lab are used to enhance, direct, or restore the natural defenses of the body against cancer. This form of cancer treatment is also known as biologic therapy or biotherapy.

The astute Dr. Ewanowski’s skin care clinic is equipped to provide advanced medical and aesthetic skin care solutions to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brookesville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and other cities and towns in this area of the southeast.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.