Sunburn that can occur in as little as fifteen minutes can cause permanent irreversible damage and can add up with each exposure to the sun. South Africa has one of the highest monitored ultraviolet (UV) levels in the world, and one of the highest skin cancer rates globally.
It was only in the early 1980’s when the danger of ultraviolet light and excessive exposure to the sun started to become apparent, and that our habit of worshipping the sun was leading to more and more problems.
One increasing problem with repeated sun exposure is Actinic Keratoses, or AK which is also commonly referred to as Solar Keratosis. These are flesh-coloured or slightly brown pigmented, rough scaly patches or growths that occur most commonly on the face, lower lip, bald areas, head, scalp and back of the hands.
These areas of thickened skin can also become very itchy, and scratching them can cause even more problems, and can lead to the development of large abnormal tissue growth.
Risk factors for developing AKs include older age, with a slight male predominance, yet according to Dr Sian Hartshorne, a Dermatologist in Plettenberg Bay, more and more patients in their 40’s and even their 30’s are presenting with AK’s due to cumulative sun exposure.
The danger with AK’s is that they are considered precancerous, and if left untreated, can develop into a type of skin cancer called squamous cell carcinoma, the second most common form of skin cancer. Furthermore, most people who have AK’s, will continue to develop new AKs for life.
The best way to prevent AK’s is to avoid sun exposure, especially those who are at a higher risk because of a fair skin.
According to Dr Hartshorne, this includes covering up with clothing, using sunscreens with high SPF factors and wearing sunglasses. “Daily sunscreen is essential in preventing the development of AK,” she says. Interestingly, she adds that it is also the moisturising effect of the daily application of sunscreen than can flatten and decrease the dry, flaky, and itchy symptoms of AK and can help to prevent people from scratching them.
In fact, she says that daily application of a broad-spectrum sunscreen can decrease existing AKs by 30%.
In addition to the use of sunscreen, widespread AKs on the arms and legs can be softened and sometimes reduced in number by the use of combination moisturising creams containing salicylic acid or lactic acid, states Dr Hartshorne.
The bottom line is that all AKs should be treated, and that the risk of progression of an AK into skin cancer can be minimised by effective treatment.
There are many types of treatment options which your dermatologist might recommend. These could include:
- Freezing the skin growth with liquid nitrogen, which is called cryotherapy
- Scraping, which is when the skin is numbed, and the growth is scraped off using a spoon-shaped instrument
- This can be followed by electrosurgery to control any bleeding and destroy any remaining abnormal cells
- Shaving the growth with a surgical blade
- Chemical peels
- Laser resurfacing
There are also non-invasive topical treatments and creams available, which can be prescribed by a General Practitioner (GP) or dermatologist and applied at home, for a specified number of weeks which can have excellent clearance rates and less chance of recurrence compared to some of the other treatment options list above. This includes an immune response modifier, which is a topical treatment that works by activating your immune system to target and destroy AKs, while not harming the healthy surrounding cells.
While many of us may have done a little too much sun worshipping in our youth, and may now be dealing with issues such as precancerous Actinic Keratoses, what can we teach our children so that they do not make the same mistakes we did?
Fortunately, many children today have adopted the application of daily sunscreen as a healthy habit, but Dr Hartshorne reminds us that we need to continue to encourage wearing sun protective clothing, and repeated applications, as sunscreen does not last all day.
Please see your general practitioner or dermatologist should you be concerned about any lesions on your skin, including if you notice a new lesion or changed mole.
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