What treatments are available for actinic keratosis?
Ask the doctor
Q. I developed a skin spot of what I think is actinic keratosis. I have made a dermatology appointment to have it looked at. What might I expect to learn about the treatments?
A. Actinic keratoses are rough, scaly areas on skin that often feel like sandpaper. They are found on areas of the body exposed to the sun. They are precancers, which means they could turn into squamous cell skin cancers if they are not treated.
People with light skin are more susceptible to getting actinic keratoses, but anyone can get them. That's why it is important to protect the skin by wearing sunscreen and protective clothing.
There are several ways to treat actinic keratoses. A dermatologist can spray liquid nitrogen on these precancers. The area will often then blister, and the precancer can go away in two to three weeks. If it does not go away, it should be retreated or biopsied.
Actinic keratoses can also be shaved or scraped off, if the number of precancers is not large. To avoid infection, you will need to apply antibiotic ointment and keep the area clean.
The dermatologist may discuss the use of topical prescription creams, such as 5-fluorouracil (5-FU) in Efudex or Carac or imiquimod (Aldara). The cream is applied for two or three weeks. The skin will become irritated and sometimes bleed, but usually these precancers go away. Another longer-term topical option is diclofenac 3% gel (Solaraze), which is milder.
Photodynamic therapy can treat actinic keratoses. A photosensitizing substance is applied to the skin. The skin is then exposed to a light source such as ultraviolet light. The photosensitizing substance soaks into the actinic keratoses and is "activated" by the light source. This destroys the precancers. There is some pain with this process, but it usually lasts only five to ten minutes. You must avoid sun exposure for at least 48 hours after the treatment and wear sunscreen diligently.
I suspect your dermatologist will recommend scheduling periodic skin exams if the diagnosis is confirmed.
Image: © Eric Audras/Getty Images
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