Sun exposes your skin to
the risk of Actinic Keratosis.

To find out more about Actinic Keratosis, follow this sunbeam.

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What is
Actinic Keratosis?

Actinic Keratosis, also called solar keratosis, is a pre-cancerous chronic skin condition linked to over-exposure to the sun. The UV rays from the sun cause damages to the surface of the skin, particularly in the DNA of keratinocytes. These damages can induce mutations in the DNA of these cells, sometimes leading to their abnormal and uncontrolled proliferation causing the appearance of Actinic Keratosis.

The condition mainly affects areas most exposed to the sun, such as the scalp, face, ears, and extremity of
upper limbs. ⁽²⁾

Age and sex are two predisposing factors for
Actinic Keratosis, which primarily affects
men and older people. ⁽²⁾

The sun is known to be the main causative factor of Actinic Keratosis lesions. Occupations and activities that involve spending long periods in the sun each day also carry a higher risk of Keratosis. ⁽²⁾

A study led in Austria found out that about 1 person out of 3 after 60 years old is affected by Actinic Keratosis (and more than 1 person out of 2 after 70).⁽³⁾

KER'INFO

Actinic Keratosis is more common in sunnier countries with fair skin population: in Australia, it affects one in every two people of Caucasian origin over the age of 40. ⁽⁴⁾

What does Actinic
Keratosis look like?

Actinic Keratosis lesions look like small blemishes, scabs or spots that may appear gradually. They are very dry, rough (they feel like sandpaper to touch) and varied in terms of shape and colour (sometimes red and/or brown)

At the more advanced stage, the lesions can become ulcerated and swollen, and begin to bleed or weep.

Actinic keratosis on the nose

Multiple lesions forming field cancerization on the scalp *

Hyperkeratotic lesion on the left ear *

Hyperkeratotic lesion *

The lesions may be quite discrete: see here on the upper and lower cheek

Lesion with actinic keratosis ulceration

Ulcerating lesion *

Field cancerization at the crown of the head *

The diagnosis of Actinic Keratosis is carried out by a
dermatologist or a general practitioner depending on the country
*Pictures from dermaweb.com

KER'INFO

Global prevalence of Actinic Keratosis has dramatically increased in recent decades. ⁽⁵⁾

Clearly visible lesions... And hidden damage too!

Actinic keratosis lesions can be visible at the surface of the skin or hidden under the skin surface but always in the sun-damaged area. Together, visible and non-visible lesions are the field cancerization. Therefore, they can develop into invasive carcinoma, that means they can go through the deeper layers of the skin and reach the blood vessels.

Actinic keratosis are precancerous lesions that can regress or stay at the early stage of in situ carcinoma (visible or not) or can develop into invasive carcinoma. ^(6-7)

Visible lesions only

Visible and non-visible lesions

Slide the bar to reveal all the lesions

GRADE I*

Early in situ squamous cell carcinoma type AK I
(mild Actinic Keratosis)

*According to the ROWERT-HUBER histological classification⁽¹⁾

GRADE II*

Early in situ squamous cell carcinoma type AK II
(moderate Actinic Keratosis)

*According to the ROWERT-HUBER histological classification⁽¹⁾

GRADE III*

In situ squamous cell carcinoma type AK III
(severe Actinic Keratosis)

*According to the ROWERT-HUBER histological classification⁽¹⁾

Invasive squamous
cell carcinoma

Show labels

Skin surface

Epidermis

Dermis

Blood vessels

Hypodermis

When Actinic Keratosis develops into invasive squamous cell carcinoma

There is a risk, albeit a small one, of Actinic Keratosis developing into invasive squamous cell carcinoma (non-melanoma skin cancer).

Actinic Keratosis accounts for 65% of invasive squamous cell carcinomas. The risk of developing this form of carcinoma can therefore be considerably reduced by treating any Actinic Keratosis lesions.⁽⁸⁾

Like high grade Actinic Keratosis, low grade Actinic Keratosis
can turn directly into invasive squamous cell carcinoma.⁽⁹⁾

It is impossible to predict which Actinic Keratosis lesions will develop into cancer : which is why it is recommended to treat every lesion.^(9-10)

For illustration only

Note: Some lesions cannot be seen with the naked eye. There is no clearly established correlation between visible lesions and what is happening beneath the skin.

Grade I

Grade II

Grade III

Invasive carcinoma

The sun has benefits.

Sunlight has a positive effect on our bodies, mainly by triggering the synthesis of vitamin D in our skin.

Exposure to the sun for at least 5–15 minutes twice a week during the early afternoon is usually enough for the body to produce vitamin D.

But UV rays are harmful.

In high doses, the sun becomes the arch enemy of our skin.

The most common problem is sunburn, which can vary in severity depending on phototype and degree of exposure. Repeated over-exposure also speeds up the skin aging process (premature wrinkles, blemishes, etc.).

These effects of the sun on the skin are mainly related to ultraviolet rays. In the long term, they can damage the DNA of cells and induce the development of skin cancer.

Simple ways to protect your skin

Fortunately, there are lots of ways to keep well protected from the sun.

Avoid exposure
between 11am
and 4pm

Wear long sleeves,
pants or skirts, a hat,
and sunglasses.

Apply sunscreen 20 minutes before going out, then every 2 hours to all exposed areas, not forgetting your ears, hands, and neckline.

Use sunscreen with a high sun protection factor that is waterproof and contains photostable ingredients.

KER'INFO

Find the best texture and formulation of sunscreen for your targeted skin area.

Actinic Keratosis is more common in certain situations. ⁽²⁾

Sun is the leading cause of Actinic Keratosis, but not everyone is equally at risk under the sun. Skin type is also an important factor : each person’s skin is unique, with its own color and sensitivity to the sun : This is known as the phototype.

Some outdoor occupations and activities involve greater exposure to the sun than normal, which increases the risk of Actinic Keratosis and skin cancer.

Chronic over-exposure to strong UV light

Fair skin - phototypes I and II

Older age

Compromised immune system

Men

KER'INFO

The UV Index explains how harmful the sun’s UV radiation is at any given time and place.

Different types of skin phototypes. ⁽¹¹⁾

Discover the different skin types and the different risks associated with sun exposure. What about you? What is your skin type?

Type IType IIType IIIType IVType VType VI

Very pale, milky-white skin

Often red or blond hair, with lots of freckles. Always burns, never tans, very sensitive or even intolerant to sunlight.

Very fair skin

Hair is usually blond to light brown. Often has freckles. Always burns, tans very slowly and gradually.

Average skin color

Medium to brunette hair, may have some freckles. Sometimes burns, tans slowly (moderate tan).

Move the target to select your skin type

Light-brown skin

Brown or black hair. No freckles. Never burns, tans easily (deep tan).

Brown skin

Black hair. No freckles. Never burns, tans very easily (very deep tan).

Black skin

Black hair. Never burns.

KER'INFO

The sun is a key factor in the onset of Actinic Keratosis, and fair-skinned people are more likely to be affected because they have less natural protection.

If Actinic Keratosis appears,
treatments exist. ⁽¹²⁾

CRYOTHERAPY

This is the technique most widely used by dermatologists to treat isolated Actinic [...]

This is the technique most widely used by dermatologists to treat isolated Actinic Keratosis. Liquid nitrogen is applied directly to the lesion at a temperature of -196°C and forms ice crystals. This kills the cells in the epidermis (keratinocytes) and the lesion falls off the skin.

There are lots of ways to surgically remove Actinic Keratosis lesions and they can be quite painful […]

There are lots of ways to surgically remove Actinic Keratosis lesions and they can be quite painful. Excision (cutting away) and curettage (scraping) are only used for lesions (the most prominent). Dermabrasion is a bit like planing the surface of the skin, and is widely used to treat Actinic Keratosis on the forehead and scalp.

PHOTODYNAMIC THERAPY

This technique destroys the lesions by applying a photosensitizer […]

This technique destroys the lesions by applying a photosensitizer which, when activated by light, releases a toxic agent into the Actinic Keratosis lesions.

CREAMS, GELS, AND OINTMENTS

There are lots of topical treatments that get applied directly to the lesions […]

There are lots of topical treatments that get applied directly to the lesions.

These treatments can target several lesions at once and can be applied to the whole field cancerization.

KER'INFO

Discussion between patient and doctor is crucial to ensure a correct understanding of the condition and the treatment.

Advice from an expert

Prof. Eggert Stockfleth, Dermatologist and Head of the ESCF (European Skin Cancer Foundation) talks about the condition.

For more information

The ESCF (European Skin Cancer Foundation) works to develop and provide standardized prevention strategies and treatment guidelines at European level, thereby helping to improve the treatment of skin cancer and promote best treatment practices through training and the sharing of knowledge.

Find out more

Take care of your skin
and if in any doubt,
please consult a specialist.

At Pierre Fabre, we take care of people as a whole, in all their diversity. From health to beauty, we have adopted a unique approach that allows us to make a positive contribution to the overall well-being of individuals. This complementarity is a key element of our global skin cancer program, United Against Skin Cancers.

Our expertise in dermatology, combined with our knowledge of oncology, puts us in a unique position for fighting skin cancer from multiple angles. United Against Skin Cancers brings together numerous global initiatives inspired and developed by Pierre Fabre around our three core values of care: prevent, treat, and support.

Find out more

Pierre Fabre is engaged for decades in fighting skin diseases, inclunding skin cancer and actinic keratosis.

The awareness campaign AK IS NOT OK! has been created by Pierre Fabre to make this disease better known by the general population in order to encourage the early diagnosis of Actinic Keratosis. Treated early, the risk of developing a non-melanoma skin cancer can be considerably reduced.

To be sure not to miss any communication on Actinic Keratosis, follow Pierre Fabre on:

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Sun exposes your skin to
the risk of Actinic Keratosis.

What is
Actinic Keratosis?

What does Actinic
Keratosis look like?