What is actinic keratosis?
Also known as solar keratosis, actinic keratosis (AK) is a growth that develops on skin that is exposed to sunlight. It happens on sun-damaged skin, particularly on the hands, forearms, face, and neck. AK appears as a reddish/brownish, rough and scaly or crusted area of skin and usually begins in ones 30s or 40s, which means that can co-exist with pregnancy.
How common is actinic keratosis in pregnancy?
AK is very common overall, but its prevalence varies depending on traits of populations and on latitude, as it is more common in fair-haired, light-skinned people at low latitudes where exposure to sunlight tends to be high throughout the year. The prevalence is thus highest in Australia, where a reported 40-60 percent of Caucasians are affected, although women and people below age 40 are affected in much lower numbers. In comparison, AK prevalence in the United Kingdom, located at high latitude has been reported at only 19-24 percent even among people above age 60. What all this means is that you are more likely to develop AK if you are fair-haired and light-skinned, living at a low latitude location and if you spend a lot of time in the sun.
How is actinic keratosis diagnosed?
AK is diagnosed based first on your history of sun exposure, following by examination by your primary physician or dermatologist. AK lesions appear as reddish or brownish, sometimes tan, colored rough patches, generally 1-3 millimeters in size. The physician may then perform a skin biopsy of the lesion, which will be examined in the laboratory to distinguish between AK and types of skin cancer known as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Does actinic keratosis cause problems during pregnancy?
AK can burn, itch, sting, or bleed and develop into sores. AK is not a cancerous growth, but over time it can change into SCC.
Does actinic keratosis during pregnancy cause problems for the baby?
AK does not cause particular problems for the baby, as the effects are limited to your skin.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the AK
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat actinic keratosis during pregnancy?
Medications used for AK are applied directly to the skin and include 5-fluorouracil (5FU) cream, Diclofenac gel, Imiquimod cream, and Ingenol mebutate gel. Since 5FU is known to cause birth defects and spontaneous abortion (miscarriage), it should be avoided during pregnancy, even though it is applied as a cream and most likely only very tiny amounts will get absorbed into your bloodstream.
Who should NOT stop taking medication for actinic keratosis in pregnancy?
As noted above, most of the creams that are applied to the AK skin lesions are not thought to be dangerous during pregnancy, so there is no reason to stop using them.
What should I know about choosing a medication for actinic keratosis in pregnancy?
You may find Pregistrys expert reports about the individual medications to treat AK here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for actinic keratosis when I am breastfeeding?
If you are using medicated creams or gels on your skin, you should be extremely careful to keep the medication away from your breasts where the infant nurses, and be careful to wash the cream or gel from your hands before you touch your baby.
What alternative therapies exist besides medications to treat actinic keratosis during pregnancy?
Treatments for AK include various surgical procedures, such as cryotherapy (freezing the lesions with a cryoprobe), scraping (also known as curettage), and chemical skin peeling. Another treatment, called photodynamic therapy, exposes the lesion to an agent that makes cells very sensitive to a certain color of light. The AK lesion is then exposed to that type of light to remove it.
What can I do for myself and my baby when I have AK during pregnancy?
Cooperate with your dermatologist regarding treatment strategies. Also, take actions to prevent AK, or to prevent additional AK lesions from forming, by protecting your skin from the sun. Wear protective clothing, such as a hat, a long-sleeved shirt, pants, and sunglasses with ultraviolet light protection. Use sunscreen that blocks both UVA and UVB rays and that has a sun protection factor (SPF) of 30 or higher. Avoid tanning booths and long periods of time in the sun, especially during the times of day when sunlight is strongest.
Resources for actinic keratosis during pregnancy:
For more information about actinic keratosis during pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:
- Mayo Clinic: Actinic Keratosis
- Skin Cancer Foundation: Actinic Keratosis: Warning Signs and Images
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.