When doing a self-screening, it’s important to understand differences between certain skin lesions. Today’s focus is on actinic keratosis vs seborrheic keratosis. Let’s dive in.
While there are both similarities and differences in actinic keratosis vs seborrheic keratosis that are important to know, it’s also important to understand what keratoses are. Keratoses are keratinocyte cells that grow abnormally to form a keratin skin growth. While keratoses are caused by damage to the same types of cells (keratinocytes), the growths that result from this damage are different.
What is Actinic Keratosis?
Actinic keratosis is often caused by sun damage and results in scaly or crusty growths. They are commonly found on areas of the skin that are exposed to sunlight over a long period of time, such as the hands, ears, lips, necks, and shoulders. Actinic keratosis is pre-cancerous and can develop into skin cancer. You may have heard of skin cancer being characterized as basal cell carcinoma or squamous cell carcinoma. Actinic keratoses only develop into squamous cell carcinoma.
What is Seborrheic Keratosis?
Seborrheic keratoses are a common form of non-cancerous skin lesions that appear as you age. They are often brown or tan in color and form on the chest, head, back, or neck. People usually have these removed for cosmetic reasons or to prevent them from catching on clothing or jewelry. Seborrheic keratoses never form into skin cancer.
How Can You Tell the Difference Between Actinic Keratosis vs Seborrheic Keratosis?
The appearance of actinic keratoses and seborrheic keratoses is very similar. Seborrheic keratoses are often mistaken as skin cancer. Actinic keratosis forms into scaly, dry, crusty patches of skin called plaques. These patches or plaques often form in clusters.
Plaques don’t move and are usually flat or only slightly raised. These lesions are often easier to feel than to see as they are rough in texture but can be skin colored. At times, these growths may also be red, tan, white, or a combination of colors. Actinic keratoses can bleed easily and may take longer to heal. In some cases, the patches may be very sensitive, burn, or itch.
Seborrheic keratoses can vary in how they appear. These growths are often rough and feel crumbly in texture, but sometimes can be smooth and waxy. They can range in color from light tan to black. These growths often look as if they have been stuck on the skin like a sticker. Seborrheic keratoses can also vary in size, ranging from very small to larger than three centimeters.
Similar to actinic keratoses, seborrheic keratoses are usually flat or slightly raised. They also form plaques that can either form alone or in a cluster. They also may bleed easily and become itchy. These can form quickly and should be watched for additional changes in shape, color, and size.
What Causes Actinic Keratosis and Seborrheic Keratosis?
Actinic keratosis is most often caused by extended exposure to sunlight or artificial sunlight, like that found in tanning beds. This does not mean you will form actinic keratosis after spending a day in the sun. Actinic keratosis forms after years of exposure to the sun and/or artificial sunlight.
People are more likely to develop actinic keratosis if they are fair skinned. Actinic keratosis most often forms in people over the age of 40 and is more common in men. People who have outdoor occupations, live in sunny climates, and have experienced frequent sunburns are at a higher risk of forming actinic keratosis. People who have used tanning beds often are also at increased risk.
Seborrheic keratosis differs from actinic keratosis in that it is not caused by sun exposure. While the cause of seborrheic keratosis is unknown, most people who form seborrheic keratoses often have a family history of the condition. Most people develop seborrheic keratoses when they are 50 and older. While seborrheic keratoses are not linked to any type of skin cancer, they have been linked to cancer in other parts of the body
What are the Treatment Options for Actinic Keratosis vs Seborrheic Keratosis?
It is important to identify if skin lesions are actinic keratosis vs seborrheic keratosis as treatment options do differ. Your dermatologist will offer a variety of treatment options for actinic keratosis based on the size and location of the lesion. These options include medication, topical treatments, cryotherapy, or an outpatient surgery.
Oral retinoids are commonly used to treat actinic keratoses that appear in multiple areas of the body. Topical creams used for lesions that appear in many areas on the body include 5-fluorouracil cream, tretinoin, and ingenol mebutate gel, as well as many others. Medication and topical therapies help clear large areas of the skin while reducing the risk for scarring and infection.
Cryotherapy is used to freeze damaged cells by using liquid nitrogen to remove and destroy these cells. This treatment is recommended for small to medium sized lesions and does have minimal risks associated with it. These risks include blistering, scars, and change to the skin tone.
Outpatient surgical options can include curettage and electrocautery. Curettage is a process that scrapes away layers of skin cells at time to minimize risk of scarring, while also making sure to remove all affected skin cells. At Vujevich Dermatology, this procedure is conducted in our state-of-the-art Ambulatory Surgery Center. Electrocautery is often used following curettage to reduce bleeding and minimize risk of infection.
Often, dermatologists do not recommend treatment for seborrheic keratosis. However, people may opt to have them removed if they often catch on clothing or jewelry or for cosmetic reasons. Seborrheic keratoses are often removed using cryosurgery, curettage, electrocautery, laser ablation, or topical treatments. Laser ablation uses lasers to destroy the lesion. Topical treatments are used to dissolve the affected skin cells.
How Can I Prevent These Skin Growths?
While seborrheic keratosis cannot be prevented, there are ways to prevent actinic keratosis. Limiting sun exposure, both natural and artificial, will decrease your risk of developing actinic keratosis. When spending time outside, we recommend applying sunscreen of at least 30 SPF. You should apply sunscreen to all areas of skin exposed to the sun, including your lips. Reapply sunscreen every two hours. Protective clothing when out in the sun, such as hats, sunglasses, and long sleeves, can also decrease your risk of actinic keratoses developing.
It is also important to conduct a once a month at-home cancer screening and a yearly skin cancer screening with your dermatologist. This will help you identify differences between actinic keratosis vs seborrheic keratosis, seborrheic keratosis vs melanoma, and any other skin lesions that suddenly appear. Regular screenings also make it easier to identify if any existing skin lesions begin to change shape, color, or size. Identifying possible pre-cancerous growths early creates higher chances of positive treatment outcomes.
If you’re unsure about any new skin growths or other changes in your skin, schedule an appointment with your dermatologist to conduct an examination. Vujevich Dermatology is a trusted dermatology office with some of the most highly trained physicians and clinicians in the greater Pittsburgh area. You can reach our team at 412-429-2570 or visit our contact page to see all of our locations. You can also follow us on Facebook to see what’s new in the world of dermatology.