Sun Damage

Posted on: 25 March 2008 by Gareth Hargreaves

There's More Than Meets the Eye

There's More Than Meets the Eye

Wrinkles, fine lines and age spots aren't the only negative results of cumulative sun exposure.  One in six, or roughly 46 million Americans will develop an actinic keratosis in their lifetime, according to the Skin Cancer Foundation.  Actinic keratosis (AK), an evolving form of skin cancer, is often invisible to the naked eye.  If left untreated, up to 10 percent can turn into squamous cell carcinoma, a type of skin cancer that can be fatal.  People aged 50 and over who have had significant sun exposure or a history of repeated sunburns and those who tend to freckle and burn rather than tan in the sun are at greatest risk for AKs.

Pro-golfer and two-time U.S. Open Championship winner Andy North was alarmed when he was diagnosed with an actinic keratosis.  "When my dermatologist told me I had an actinic keratosis I was nervous because I had never heard of it before.  Luckily, we caught it pretty early and were able to treat it before it turned into something more serious," said Mr. North. "I wouldn't trade my years as a professional golfer for anything, but I'm paying the price for them.  Now I know what to look out for and I also understand the importance of seeing a dermatologist regularly and wearing sun
protection year round."

Actinic Keratosis: A Deeper Issue

AKs begin under the skin's surface, then emerge as rough or scaly areas that feel like sandpaper to the touch.  They can be pink, tan, red or the same color as your skin, so they're more easily recognized by touch than by sight.  AKs are commonly found on areas that receive the most sun exposure such as the face, scalp, arms and back of hands. 

Joseph Jorizzo, MD, professor and chair, Department of Dermatology, Wake Forest University School of Medicine, believes actinic keratoses are vastly underdiagnosed.  "Actinic keratoses are an extremely common result of sun exposure that can evolve into an invasive, life-threatening form of skin cancer, but most people are unaware of AKs and do not seek the proper treatment," said Dr. Jorizzo.  "Luckily, actinic keratoses are easy to treat.  The best way to prevent an actinic keratosis from becoming a more progressive form of skin cancer is to see a dermatologist for a complete skin examination
and treatment."

Carac(TM) (fluorouracil cream) Cream, 0.5%, is a new once-a-day, topical treatment for actinic keratoses of the face and anterior scalp that has been approved by the U.S. Food and Drug Administration.  Carac provides patients with an effective actinic keratosis treatment with convenient once-daily dosing, and a rapid recovery of treatment-related irritation.  In clinical trials with Carac, this irritation generally resolved within two weeks.   "This new cream can find and treat the earliest actinic keratoses before they're even visible to the naked eye.  Using a fluorouracil cream like Carac, in combination with regular visits to the dermatologist for cancer screenings, may offer patients a real improvement in therapy," said Dr. Jorizzo.  Fluorouracil is a form of topical chemotherapy.  It mimics naturally occurring substances in the body, which are essential for cell division.  Rapidly dividing cells, such as those in actinic keratoses, absorb the fluorouracil, causing them to die.

In Carac clinical trials, the most common drug-related adverse events were application site reaction, which included: redness, dryness, burning, erosion, pain and swelling.  Some patients also experienced eye irritation, including stinging and burning.  Carac should not be used by women who are pregnant, considering becoming pregnant or nursing.  Carac should also not be used by people with dihydropyrimidine dyhydrogenase (DPD) enzyme deficiency.  Do not use Carac if you are allergic to any of the ingredients in Carac.  The active ingredient in Carac is fluorouracil.  Carac should not be used by those under 18 years of age.

An Ounce of Prevention

Prevention is good medicine.  To avoid actinic keratoses, follow careful sun protection practices.  It is important to wear a broad-spectrum sunscreen with a sun protection factor (SPF) of 15 or greater every day, year round. Covering up with protective clothing, such as long pants, long-sleeved shirts, broad-brimmed hats and UV-blocking sunglasses is also helpful.
Dermatologists recommend that adults over the age of 50 examine their skin from head to toe once every three months.  If anything unusual or suspicious is noticed, they should see a dermatologist as soon as possible.

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