Precancerous lesions are abnormal skin cell growths that have an increased risk of progressing into skin cancer. Typically, precancerous lesions start forming at age forty and up, after extensive exposure to sunlight and UV rays. However, in places that have intense sunny climates year-round – like here in Florida – people as young as twenty may begin developing precancerous lesions.
Your risk factor increases if you have fair skin, light-colored eyes or hair, skin that freckles or burns in the sun, or a weakened immune system. Age is also a risk factor.
The most common type of precancerous lesion is actinic keratosis (AK), also known as solar keratosis or sun spots. Approximately 10-15% of actinic keratoses will progress into squamous cell carcinoma. While squamous cell carcinoma is easily treatable in the early stages, if left untreated the lesions can ulcerate, bleed, become infected, or metastasize.
Here are some common characteristics to watch for:
- Small, rough patches of skin that feel like sandpaper. Initially, you may detect the presence of an AK by touch, rather than sight.
- Over time, AKs will grow into visible rough, scaly lesions. Some growths develop in a distinctive horn shape. They can range in color: white, tan, brown, pink, or red.
- The lesions may burn, itch, or be painful. They may tingle or feel especially tender when exposed to direct sunlight.
- AKs are most likely to develop on areas of the skin that get a lot of sun exposure: a bald scalp, face, lip, ears, neck, shoulders, forearms, and hands.
- AKs rarely show up alone – they form in clusters, and more than one cluster may appear at a time.
- AKs can come and go over time. Lesions may disappear for a period, only to return after you spend time outside without skin protection.
- Actinic cheilitis is the most aggressive type of actinic keratosis and it forms as a rough, scaly lesion on your lip. Actinic cheilitis has an ever higher risk of progressing to squamous cell carcinoma than other AK lesions.
The presence of any actinic keratosis – even if it disappears – indicates that skin has already suffered skin damage. If you have AKs, you are at higher risk of developing any type of skin cancer, including melanoma.
If you notice an unusual or painful growth that looks like an AK, see your dermatologist as soon as possible. Your dermatologist may take a biopsy of the growth to test for cancer. Not all actinic keratoses need treatment – your dermatologist may recommend active surveillance of the lesion for the time being. Additionally, there are various methods by which a precancerous growth can be removed: cryosurgery; curettage; photodynamic therapy (PDT); surgical excision; laser resurfacing; chemical peels; and topical medications.
Be proactive in your skin health: Even if you do not have unusual growths of lesions, see your dermatologist regularly for skin cancer screenings and learn how to identify signs of skin cancer. Before you head to the beach this summer, contact Florida Dermatology & Skin Cancer Centers and make an appointment for a skin screening.