ACTINIC KERATOSIS

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Actinic keratoses are considered precancerous spots that develop on skin that’s been damaged by years of sun exposure or use of tanning beds. These rough, scaly patches most often appear on areas like the face, ears, scalp, hands, and arms—places that get the most sun over time. If you’ve had one actinic keratosis, there’s a good chance you may develop more, and their presence also increases your risk of skin cancer. If not treated, actinic keratoses can progress into squamous cell carcinoma, a common form of skin cancer—so early evaluation and treatment are important.

Actinic keratoses can develop on any part of the body that’s had long-term sun exposure, but they most commonly show up on the face, lips, ears, scalp, and the backs of the hands—areas that tend to get the most sun over time. A specific type of actinic keratosis called actinic cheilitis can also appear on the lips, usually the lower lip, and may cause dryness, cracking, or discoloration.

Actinic keratoses often show up as small, rough, dry patches or scaly spots on the skin. They can be white, pink, red, or even dark tan in color. Because of their texture, many people notice them by touch before they actually see them—they can feel like sandpaper or a crusty bump on the skin.

Actinic keratosis can be treated in several ways, depending on how many spots are present, their location, and your skin’s overall health. The goal is to remove the damaged cells before they turn into skin cancer. Treatment options fall into two main categories: procedural (surgical) and topical (medication-based).

1. Procedural Treatments

These options are ideal for treating one or more clearly visible lesions:

• Chemical Peels: A medical-grade solution is applied to the skin to remove the outermost layer, prompting new, healthy skin to grow over the following weeks.
   
• Curettage and Cautery: The lesion is gently scraped off with a small instrument (curette), then heat is applied to destroy any remaining precancerous cells.
   
• Laser/Light Therapy (PDT): A focused beam of light is used to precisely remove the affected tissue.
   
• Cryotherapy: (Optional to include) A quick, common method where liquid nitrogen is applied to freeze and destroy the lesion—often done in a clinic visit.
   

2. Topical Treatments

These are often used when there are multiple or widespread areas of actinic damage, even in spots that may not be visible yet:

• Efudex (5-FU): Targets abnormal cells and causes peeling or crusting during treatment.
   
• Solaraze (Diclofenac): A milder option that works over several weeks.
   
• Aldara / Zyclara (Imiquimod): Boost the immune system to attack abnormal cells.
   
• Picato (Ingenol mebutate): A short-term treatment that works quickly, though reactions can be intense.
   

Topical treatments are applied at home and may cause redness, scaling, or discomfort while the damaged skin is healing—but these are signs the treatment is working.

Field therapy refers to treating an entire area of skin that has been damaged by long-term sun exposure—not just the visible actinic keratoses, but also any hidden or early-stage lesions that haven’t surfaced yet. This approach is especially helpful for patients who have multiple spots or widespread sun damage, typically on the face, scalp, chest, arms, or hands.

To learn more about Field Therapy, Click HERE