Actinic Keratosis

An actinic keratosis (AK) is pre-skin cancer. They are small, pink, gritty scaled spots commonly found on the sun-exposed skin of the head, neck, forearms, and hands. AKs are easily detected by their fine, sandpaper-like texture.

We generally recommend treating AKs as they can turn into a skin cancer called squamous cell carcinoma (SCC). There are several ways to treat AKs.  We can ‘spot’ treat them, in the office, with liquid nitrogen spray, also known as cryotherapy.  You can ‘field’ treat them, at home, by applying a topical medication such as 5-fluorouracil, imiquimod, diclofenac, or ingenol mebutate.

A novel treatment for the removal of existing AKs and prevention of future AKs is photodynamic therapy (PDT). PDT is commonly referred to as ‘blue light’. We paint a solution on your skin called Levulan.  After letting this solution incubate on your skin for an hour or more, we then shine visible blue light on the painted skin to activate the solution.  The activated solution destroys the pre-cancerous cells.

Factors we consider when treating AKs include the number, location, and thickness of AKs.  Other considerations important to most patients include the time of year and personal factors like work, vacation, upcoming social functions, and cost.  If you have AKs, you and your dermatologist will discuss which treatment might work best for you.