Actinic keratoses, also known as solar keratoses, are precancerous lesions caused by chronic sun exposure (ultraviolet radiation) over time. They commonly present as pink to tan or pink to red rough scaly spots on exposed areas such as the face, neck, ears and arms. While these lesions are not cancerous, they may progress to squamous cell carcinoma of the skin if left alone. Squamous cell carcinoma is a common skin cancer which can invade surrounding tissue and potentially spread to other organs if left untreated. Patients who develop rough scaly spots or non-healing lesions should consult a dermatologist for evaluation.
Treatment of Actinic Keratoses
There are a variety of treatment options for the treatment of actinic keratoses (AKs). Treatment can range from in-office procedures to topical creams and gels which can be done at home.
Cryotherapy (Cryosurgery): A common treatment option for actinic keratoses in which Liquid Nitrogen is used to “freeze” and destroy precancerous cells. Treatment often results in blisters which gradually heal and resolve in 2-3 weeks.
Chemical Peels: An in-office procedure in which a chemical or acid is applied to the skin and results in the destruction and sloughing of precancerous skin cells. Patients often experience redness and peeling of the skin that can last 1-2 weeks.
Photodynamic Therapy (PDT): An in-office procedure which uses a photosensitizing agent called Levulan (Aminolevulinic Acid 20%) along with a light source to help treat sun damage and precancerous lesions. Levulan is applied to the skin and incubated for approximately 60-90 minutes where precancerous cells absorb the medicine. Following incubation, the treated area is exposed to blue light which activates the medicine resulting in destruction of precancerous cells and rejuvenation of the skin.
Topical Chemotherapy: Creams or gels applied to the skin which treat and prevent the progression of actinic keratoses. These creams can often be used in addition to cryotherapy to help “clean up” sun damaged skin and remaining precancerous cells. Side effects include inflammation and irritation of the skin.
Depending on your skin type and degree of sun damage, our dermatologist can determine what treatment options are best for you. Because actinic keratoses are due to long term sun exposure, individuals who develop these lesions are more likely to develop them again and may need routine skin examinations.