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PRE-CANCEROUS SKIN
 Pre-cancerous skin growths, also known as actinic keratoses or AKs, are found in areas of sun
-damaged skin. Actinic keratoses may represent the first sign of excessive sun damage. They appear as reddish brown, rough growths on the skin. These areas can be sensitive and easily irritated by
pressure from clothing or from sun exposure.
Over 50% of sun damage occurs before the age of 18. Sun damage accumulates over the years, with actinic damage present in over 80% of fair
-skinned individuals over the age of 60. The risk of an actinic keratosis becoming malignant ranges from less than 1% to 20% in a one-year period.
This risk is dependent on the location and degree of actinic involvement. (Statistics provided by the American Academy of Dermatology.)
Individual risk factors for actinic damage include fair skin, freckles, blue eyes, and blonde hair. Environmental factors such as excessive ultraviolet light
exposure (sun exposure or tanning booths) also play a key role.
People on immunosuppressant medications such as organ transplant patients, are particularly susceptible. Other important factors increasing
susceptibility to actinic damage include occupational x-ray exposure, environmental exposure to coal or chemicals such as arsenic, and scarring
from trauma, diseases or burns. Finally, family history plays an important role as some individuals are more susceptible to sun damage.
Recommendations:
Sun avoidance, protection and sunscreen are the basics of good skin care. Skin rejuvenation and health is accomplished by daily maintenance and sun protection.
The three most widely used treatments for healthy skin include antioxidants, Vitamin A preparations and exfoliating agents.
Antioxidants: Antioxidants are an emerging concept in skin health and maintenance. The sun’s ultraviolet radiation produces skin damaging free
radicals that are absorbed and neutralized by antioxidants. The most common antioxidants are Vitamins A, C, E and beta-carotene.
Antioxidants are most effective when applied topically. Topical Vitamin C is
the most widely used. In addition to its antioxidant properties, topical Vitamin C stimulates cell replication and collagen production. The result is a
thickening of the skin with a reduction in the appearance of fine lines and wrinkles.
Vitamin A: Vitamin A is available in common forms such as Retin-A® (tretinoin) or retinol. Retin-A® is prescription strength and is stronger than
over-the-counter Vitamin A derivatives. Over-the-counter retinol, though less potent, is very effective in reversing sun damage. When used consistently,
the milder formulations provide effective treatment while avoiding many of the side effects such as redness, irritation and peeling that are associated with the prescription products. (See retinol)
 Topical Vitamin A is also essential for skin health and
maintenance. The skin has receptors that specifically absorb Vitamin A, aiding in cellular growth and differentiation. The results are impressive, with a
reduction of fine lines and wrinkles and a complexion that is smooth, supple and evenly pigmented.
<Topical Vitamin A
Exfoliation: Skin exfoliation is achieved by mild acid application to the skin. The acids currently in use are alpha and beta hydroxy acids. (See hydroxy acids.) Hydroxy acids are readily absorbed into the deeper layers of the
epidermis. Effects include superficial exfoliation and stimulation of both the epidermis and dermis. The result is skin thickening with more uniform
pigmentation and a reduction in the appearance of fine lines and wrinkles.
What treatment regimen is right for you?
Dermatologists uniformly agree that skin health and maintenance should be addressed twice daily using one product in the morning and another in the
evening. If a simplified regimen is tolerated, products can always be added and combined based on individual goals and preferences.
Remember, damaged skin is the result of many years of sun exposure. Expect improvement to occur gradually with a consistent daily program of skin care maintenance.
The American Academy of Dermatology supports the proposal that actinic damage should be treated due to the possible progression to skin cancer.
Treatment involves, but is not limited to, cryosurgery (liquid nitrogen freezing), scraping and heat destruction (curettage and electrodesiccation), chemical
peels, laser therapy, and topical chemotherapy. See your dermatologist for a thorough skin exam and recommendations for preventative skin care maintenance.
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