Actinic keratoses

Actinic keratoses represent sun-damaged skin regions and mainly occur on body parts exposed to sunlight. Some actinic keratoses may heal naturally, particularly those that are smaller and less severe. However others require intervention. Individuals with a history of one actinic keratosis are likely to develop more in the future. Actinic keratoses are associated with a small increase in the risk of developing skin cancers in the future and this risk is reduced if they are treated.

The most commonly used treatments are cryotherapy and topical treatments. A full list of treatment options is below:-

• Cryotherapy (freezing): This is a good option when there are a small number of lesions. You can learn more at the following link: cryotherapy
• Topical treatments (most commonly efudix or sometimes imiquimod): This is good for treating a larger area or where there is a larger number of lesions. There will be a significant inflammatory reaction. Generally these are applied for 4-6 weeks, however there is some evidence that a short course of 5 days can also be effective. You can learn more about efudix at the following link: efudix
• Milder topical treatments (solaraze) - this can be useful for treating wider areas with early actinic keratoses but often do not completely eliminate lesions. It is usually associated with less inflammation than efudix or imiquimod. You can learn more at the following link: solareze
• Curettage and cautery: This is more suitable for thicker lesions or where there is concern that there may be skin cancer. The removed lesion can be sent for pathological analysis however there is more potential for scarring. You can learn more at the following link: curettage and cautery
• Photodynamic therapy: This is used for one or a small number of lesions. A gel is applied to the lesion for 1-2 hours and then either a powerful light or sunlight is shone onto the lesion for 10-15 minutes. This can be painful. The lesion will usually become inflamed and sore. You can learn more at the following link: photodynamic therapy
• Daylight photodyamic therapy: This is used to treat larger areas such as the scalp or forehead. A gel is applied and then you will be exposed to sunlight for 2 hours. You can learn more at the following link: photodynamic therapy Carbon dioxide laser resurfacing: This can be very effective for actinic keratoses and sun damage, however it has significant downtime and some risks. You can learn more at the following link: carbon dioxide laser