One of the most commonly diagnosed conditions we see in our practice is actinic keratosis. These are otherwise known as precancerous growths.
They are recurrent scaly or rough spots that do not resolve, and might occasionally be tender or burn.
Typically, these lesions are a direct result of years of sun exposure.
Oftentimes, a patient will explain that they are now diligent with their sunscreen use, or regularly wear protective clothing while outdoors. They seem confused or upset that with these lifestyle modifications, they still develop precancerous growths.
Actinic keratosis (AK) develops as a result of a cumulative total of UV radiation from a person’s lifetime, and not just from current exposure.
Does this mean that it is not necessary to continue with smart sun protection since the damage has already been done? The answer is no. One of the best ways to prevent further damage is to wear sunscreen with an SPF of at least 30, and reapply every two hours.
Alternately, the use of protective clothing, such as wide-brimmed hats or photo protective shirts, is preferred over or in conjunction with sunscreen.
There are many different treatment options available for the treatment of actinic keratosis, and not all options are appropriate for all patients.
The treatment often used in the office to treat AKs is liquid nitrogen, or cryotherapy. This form of treatment essentially freezes the lesion, creating a blister that eventually crusts over and heals. This is a good option used to treat individual lesions.
The downside is that it is site specific, and not a treatment for large patches of sun-damaged skin.
A more thorough option for treating large areas with multiple lesions is the use of topical chemotherapy agents. These agents each work in a different manner to destroy precancerous cells.
The benefit to these creams is that they can treat entire areas and take care of underlying damage. However, they will create extreme redness, scaling, scabbing and swelling during treatment, which can deter some people from using these treatments.
A third treatment option is photodynamic therapy, also known as blue light. This is an in-office medical treatment in which a liquid solution is applied to the skin being treated, then the patient is placed under a light for a short period of time.
The patient will develop redness and peeling similar to a sunburn over the course of the following week, which will lightly remove the sun damaged skin. Multiple treatments might be required.
If you have some suspicious lesions that are scaly, persistent and located in sun-exposed areas, a visit to your dermatologist might be helpful in determining whether they are precancerous growths.
A thorough conversation with your provider will help guide you to the most appropriate treatment for you.
Kristina A. Ford, MS, PA-C is an associate with May River Dermatology.