ACTINIC KERATOSIS
WHAT IS IT?
Actinic Keratosis are very common pre-cancerous growths. They turn into either basal cell or squamous cell carcinoma at a relatively low rate and are most commonly treated with cryotherapy (liquid nitrogen). If actinic keratosis do not go away with cryotherapy, there is a risk they are a skin cancer and may require a biopsy. If you have any lesions that were treated with cryotherapy at your visit that do not go away within 1 month, please call to schedule a follow-up appointment to discuss further evaluation.
TREATMENT
They can be treated using an approach of “Field Therapy”. Field therapy destroys both the actinic keratosis that we can clinically identify today and also destroys the small precursor lesions that are not apparent yet. The most common and effective Field Therapy Treatments are below.
5-FLUOROURACIL (EFUDEX)
This is a topical chemotherapy cream that you will apply 2 times per day for 2 weeks to areas requiring treatment. This should not be placed in the groin area or on mucous membranes as it can cause a severe reaction. The full 2 week course often causes significant redness, irritation and in certain cases pain and even bleeding, so please schedule this treatment around a time where you do not mind your face being red (ie do NOT use prior to a wedding, family photos, business engagement, etc)
PHOTODYNAMIC THERAPY (PDT OR BLUE LIGHT)
(Also known as PDT or Blue Light.) A sensitizing medication is applied to the skin that is preferentially absorbed by actinic keratosis over the course of 1-3 hours. After sensitization, a Blue Light is shown on the skin which activates the sensitized cells, destroying them. Similar to 5-Floururacil, there will be significant redness for a period of several days, and in certain individuals redness can last up to 2 weeks.
Actinic keratosis can be reduced by the regular use of sun protection strategies such as sunscreen, hats, clothes, shade, and avoidance during peak hours. Additionally, the use of an oral supplement (Nicotinamide 500mg) can be taken 2 times per day to reduce the number of actinic keratosis and certain skin cancers.
