Actinic keratoses affects 58 million people in the US. Up to 10% of these lesions may become skin cancers. Most commonly they become squamous cell skin cancers, but occasionally they may become a basal cell skin cancer. It is for this reason that dermatologist recommend treatment of these lesions.
Cryotherapy & Freezing
The most common treatment for actinic keratoses is cryotherapy or freezing. This treats individual lesions. The advantage of this is that it is performed by a physician at the office. It is a quick procedure and the healing process lasts about 1 week. The disadvantage is that it only treats individual lesions not the entire area. Generally, the spots that are obvious are just the tip of the iceberg. There is usually more underlying damage than can be seen.
Treatment may also involve the use of topical creams such as:
- Efudec, Carac, Fluoroplex (fluorouracil)
- Solaraze (diclofenac)
- Aldara, Zyclara (imiquimod)
- Picato (ingenol mebutate)
Application of these creams may result in redness, pain, sensitivity, and scabbing of the lesions. The process may take several weeks to heal the spot(s) completely, but when admitted properly these treatments are usually very effective in the destruction of precancerous lesions.
Blu-U Blue Light Photodynamic Therapy Illuminator
Another treatment option is Blu-U Blue Light Photodynamic Therapy Illuminator. This is currently considered the most effective treatment for actinic keratoses of the face and scalp. Treatment consists of application of a light sensitizing medication which is preferentially absorbed. There is a 1 hour waiting period then the face or scalp is exposed to a horseshoe shaped blue light. There may be stinging, tingling, or a burning sensation in the areas which are reacting most strongly. We do recommend taking an anti-histamine such as Claritin (loratadine) prior to the treatment to help minimize this. The treatment under the light lasts for 16 minutes and 40 seconds. The most uncomfortable part is the first 6 minutes. We do provide a fan to reduce the discomfort. The treatment should be repeated 6-8 weeks from the first one. Post treatment sunlight and strong lights should be avoided for 48 hours. After that time no special precautions are necessary.