Actinic Keratosis

Birthmarks are abnormal skin discolorations in spots that are either present at birth or appear shortly thereafter. They can be flat or slightly raised from the skin. They can be any number of colors, including red, brown, black, tan, pink, white or purple. Birthmarks are generally harmless. There are two major categories of birthmarks: pigmented birthmarks and red birthmarks.

Pigmented Birthmarks can grow anywhere on the skin and at any time. They are usually black, brown or skin-colored and appear singly or in groups. They can be moles (congenital nevi) that are present at birth, Mongolian spots, which look like bluish bruises and appear more frequently on people with dark skin, or café-au-lait spots that are flat, light brown or tan and roughly form an oval shape.

Red Birthmarks (also known as macular stains) develop before or shortly after birth and are related to the vascular (blood vessel) system. There are a number of different types:

  • Angel kisses, which usually appear on the forehead and eyelids.
  • Stork bites, which appear on the back of the neck, between the eyebrows on the forehead, or on eyelids of newborns. They may fade away as the child grows, but often persist into adulthood.
  • Port-wine stains, which are flat deep-red or purple birthmarks made up of dilated blood capillaries (small blood vessels). They often appear on the face and are permanent.
  • Strawberry hemangiomas, composed of small, closely packed blood vessels that grow rapidly and can appear anywhere on the body. They usually disappear by age nine.
  • Cavernous hemangiomas are similar to strawberry hemangiomas but go more deeply into the layers of the skin. These can often be characterized by a bluish-purple color. They also tend to disappear naturally around school age.

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Also known as solar keratosis, actinic keratosis affects more than 10 million Americans. These precancerous growths on the skin are caused by overexposure to the sun over a long period of time. They are characterized by rough dry lesions or patches that appear on sun-exposed areas of the skin, such as the face, back of hands, arms, scalp or shoulders. The lesions may be red, pink, gray or skin colored. Lesions often begin as flat, scaly areas and develop into a rough-textured surface. Sometimes it is easier to feel a growth than it is to see it.

Actinic keratosis is more common among fair-skinned people and those who have had years of outdoor or tanning bed exposure to ultraviolet light. Actinic keratosis can develop into malignant cells, typically squamous cell carcinoma, which is a type of skin cancer. That's why treatment isimportant. After a physical examination and biopsy of the lesion, your dermatologist will opt for one of the following treatments to remove the growth:

  • Cryosurgery, which freezes off the growth using liquid nitrogen.
  • Surgical removal in which the doctor scrapes off the lesion and bleeding is stopped by electrocautery.
  • Chemical peels that cause the top layer of skin to peel off.
  • Photodynamic therapy in which a dye is applied that sensitizes the skin to light and the area is then exposed to light via a laser or other light source.
  • Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDS) that cause a slow inflammation and peeling; used in more superficial cases.
  • Topical Chemotherapeutic agents (5 Fluorouracil, Aldara) can also be used.