Once actinic keratosis is diagnosed, the doctor will discuss a treatment plan with you in detail. Most of the goal of this website – which is for patients or their friends, family, caretakers, to identify and get to the diagnosis would be accomplished at this point. This is because early treatment is the most critical factor in managing all skin cancers, and actinic keratosis as well. They all have an extremely high cure rate if treatment is started early. This treatment section will provide a very general overview for
some of the treatment options that may be presented to you.
The optimal treatment (or no treatment) will depend on many factors, some of it to due with the lesion itself, as well as patient-centered factors such as the patient’s age or preference. As a patient, it’s part of your responsibility to communicate well with the physician and to understand the treatment options that are being presented. This guidelines will provide brief information about common treatments for actinic keratosis.
Cryosurgery is the most widely used treatment for AKs. Cryosurgery, as the name suggests, involves freezing of the AK lesion. In this treatment, liquid nitrogen is applied to the AK lesion with an applicator or a spray device. The procedure is generally performed at the office.
Anesthesia is generally not used for this procedure.
Patients should expect several courses of cryotherapy. The treated lesion will eventually crust over, and fall off. The treated area may become red and swell up. In some cases, there will be loss of pigment in the surrounding area.
Topical treatments may be an alternative treatment for AK. The most commonly used topical treatment is 5-fluorouracil (5FU), Imiquimod, or Ingenol Mebutate may be used to treat AK. The advantage of these treatments is that they don’t require surgery, and that they may help treat subclinical lesions (ones that
can’t be seen but may potentially become AK later) in the sun damaged area.
The disadvantage is that the treatment can be painful as the treated area will become red and inflamed for several weeks. Full recovery may take several months, during which patients will be uncomfortable.
Photodynamic therapy is sometimes used to treat AK lesions that form on the face and the scalp. In this treatment, topical 5-aminolevulinic acid (5-ALA) is applied to the lesion. This medication is activated when exposed to light. In this way, the medication destroys the lesions while causing minimal damage to the surrounding healthy cells.
Curettage and Electrodessication:
With C&E, local anesthetic is applied, and the lesion is scraped off with an instrument called a curette, and then an electrocautery needle is used to dessicate (dry) out the site, destroying the AK lesions. The process may be repeated several times to ensure that the entire lesion is removed.