Actinic keratosis: Risk factors

Actinic keratosis is an area of the skin damaged by ultraviolet radiation that appears in zones exposed to the sun for years. Its appearance is variable.

About Actinic Keratosis

Risk factors

Signs & symptoms

Diagnosis

Prevention

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Why does actinic keratosis develop?

Actinic keratosis is caused by chronic exposure of the skin to ultraviolet (UV) radiation from the sun or other sources that emit UV radiation (such as tanning booths or sunbeds). UV radiation causes alterations in the DNA of skin cells. When DNA repair mechanisms are depleted or fail, these alterations lead to the onset of mutations in skin cells called keratinocytes, which in turn leads to the development of actinic keratosis.

Actinic keratosis risk factors

Sun light is the main cause of actinic keratosis. This means that we can all develop the condition. However, there are certain predisposing factors that cause UV light exposure to accumulate. You are at higher risk of developing actinic keratosis if:

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  • You are an elderly person: The longer you have been exposed to the sun, the higher the risk you have of developing actinic keratosis.
  • Your head is not well covered by hair: As there is little hair on the head, the protection against radiation decreases. Males have a higher risk to develop AK.
  • You work outdoors.
  • You play sports or other recreational activities outdoors often (golf, tennis…).
  • You live in a country close to the equator: the latitude and altitude of the place of residence influence the amount of UV radiation received.
  • You expose yourself to artificial sources of UV radiation, such as tanning beds/booths.
  • You have fair skin, or sensitive skin, freckles; have red or blond hair, and blue or lightcolored eyes: all these features predispose you to be more sensitive to UV radiation.

There are other less common factors that can also increase the risk of actinic keratosis:

  • Having a weak or weakened immune system, whether due to illness or treatment with immunosuppressants (which lower the body's defenses), for instance, as a result of having received an organ transplant.
  • Having a syndrome involving alterations in DNA repair mechanisms, such as albinism.
  • Suffering from photosensitivity. Certain drugs―for example diuretics―can make your skin more sensitive to sunlight.
  • Being exposed to toxic substances, such as arsenic, or drugs that alter normal cell functioning.

References

  1. Werner RN, Stockfleth E, Connolly SM, et al. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum – Short version [Internet]. J Eur Acad Dermatol Venereol. 2015;29(11):2069-79. Available at: http://doi.wiley.com/10.1111/jdv.13180
  2. Gohara M, Morison W, Sarnoff DS. Clothing: Our first line of defence [cited 2020 Feb 6]. In: The Skin Cancer Foundation [Internet]. New York (USA): The Skin Cancer Foundation; c2019. - [approx. 5 screens]. ]. Available at: https://www.skincancer.org/skin-cancer-prevention/sun-protection/
  3. BAD: British Association of Dermatologists. Actinic Keratoses - Also Known as Solar Keratoses [Internet]. London (United Kingdom): BAD; 2007 May [revised 2019 Nov; cited 2020 Feb 19]. 5 p. Available at: http://www.bad.org.uk/shared/get-file.ashx?id=66&itemtype=document

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