Actinic keratosis is the most common type of pre-malignant lesion seen by dermatologists. Usually taking years to develop, this condition is associated with long-term exposure to the sun’s ultraviolet rays. Actinic keratoses (AKs) affect men more often than women. AKs should be cared for because they can lead to the development of skin cancer. Treatment is inconvenient but worthwhile. And a happy side-effect of treatment is that there is often cosmetic benefit – By eliminating AKs and other precancerous areas, the skin often looks and feels younger, smoother and more attractive.
There are multiple actinic keratosis treatments available, and the right choice for the patient depends on a number of individual factors. Different treatments carry different amounts of “down-time,” the number of days when a treatment is making the skin inflamed. Whether someone has a healthy immune system is also important to consider because some treatments rely on or can interfere with the immune system. The severity and number of actinic keratoses may require stronger or repeated treatments. Hobbies, occupations, and even the time of year also come into play because some treatments require strict sun avoidance.
The most common treatment option is cryotherapy, a common procedure that can be performed in the comfort of our office. During treatment, liquid nitrogen is used to cool the surface of your skin. The resulting reddish skin is replaced with new, healthy cells. This widely used and highly effective treatment is usually well-tolerated by patients.
Photodynamic light therapy (PDT also called Blue Light Therapy) is another effective and well-tolerated treatment option. During the procedure, a special medicine is applied to your damaged skin. The skin is then exposed to a visible wavelength of light that activates the medicine and eliminates precancerous cells. This procedure is available in-office.
If someone’s immune system is functioning well and the patient has no history of autoimmune diseases (diseases such as rheumatoid arthritis or lupus in which the patient’s own immune system is attacking an organ), then a medicine called imiquimod is often worth considering. Imiquimod comes as a cream that stimulates one’s own immune system to find and eliminate actinic keratoses. A good alternative particularly for someone with moderate to severe disease is 5-fluorouracil (5-FU), a cream that targets fast-growing cells. Both imiquimod and 5-FU often require four to eight weeks of treatment and recovery. Faster topical treatments such as ingenol mebutate, and gentler longer-term (60-90 day) treatments such as diclofenac may also be considered.
Another feasible procedure is to undergo electrodesiccation and curettage. This procedure is typically saved as a last resort for when cryotherapy or photodynamic light therapy options do not work. During this procedure, the actinic keratosis is removed with a curette and then cauterized. The good news is that no stitches are necessary with this treatment.
These procedures and treatments can be performed alone or sequentially to produce the best cosmetic and clinical results.
If you notice changes in your skin, make an appointment at Premier Dermatology and Mohs Surgery of Atlanta. After performing a thorough examination and reviewing the results of any required diagnostic tests, Dr. Taylor and his team can recommend the best course of therapy to treat your condition, improve your appearance and give you healthier-looking skin.
An important point to remember is that there is no one-size-fits-all treatment when it comes to actinic keratosis. At Premier Dermatology and Mohs Surgery of Atlanta, we always use a personalized approach to ensure that each treatment is as successful as possible and is the right fit for our patient. Our office is located in Alpharetta at the corner of North Point Parkway and Webb Bridge Rd. Thank you for your interest in actinic keratoses and dermatology. We look forward to serving you!