Actinic keratosis (AK) is the most common pre-cancerous skin lesion that affects more than 58 million Americans. It can present as a rough, scaly patch or a bump. If untreated, these lesions can evolve into skin cancer. Approximately 65 percent of all squamous cell carcinomas and 36 percent of all basal cell carcinomas arise in lesions that previously were diagnosed as actinic keratoses.
Actinic keratoses occur on sun-exposed skin. Most people get exposed to UV radiation from being outside in the sun or from using tanning beds.
AKs usually appear after age 40. People who live in places that get intense sunlight all year, such as the Southeastern US and Southern California, may get AKs earlier. AKs also often appear much earlier in people who have a history of excessive sun exposure or tanning bed use.
People who are most likely to get AKs tend to be more sun sensitive due to their limited pigment. This includes those with fair skin, light hair, and light eyes. Those with a weak immune system are also at an increased risk.
You can prevent the development of AKs by protecting your skin from sun exposure, wearing a daily broad-spectrum sunscreen, and avoiding the use of tanning beds.
Because these lesions can evolve into skin cancer, it is important to treat them at an early stage. Treatment options include prescription creams that can be applied at home and office treatments such as cryosurgery in which a cold spray is applied to freeze the lesion, photodynamic therapy, chemical peel and curettage. Treatments can be performed on the face or body and can improve the appearance, as well as the health of the skin.
Cryotherapy: Destroys individual AKs by freezing them with liquid nitrogen spray. The treated skin often blisters and peels off within a few days to a few weeks.
Photodynamic therapy (PDT): PDT treats multiple AKs in one area simultaneously. A photosensitizing solution, Levulan Kerastick®, is applied to skin and is taken up by the targeted cells. While the patient is resting in a darkened room, these cells convert the photosensitizer to a light sensitive pharmaceutical compound. Laser or light source exposure activates the light sensitive compound to eliminate the targeted cells, such as precancerous cells. Photodynamic treatments are safe, effective and well tolerated by most patients, but typically care must be taken to avoid exposure to sunlight for 48 hours following the treatment.
Chemical peels: This is a medical-grade chemical peel that destroys the top layers of skin. The treated area will peel off, but healthy new skin will replace it.
Curettage: A single thick AK is removed with an instrument called a curette. After curettage, electrosurgery is used to burn and remove more damaged tissue. New healthier skin will appear in its place.
Dr. Curcio specializes in Skin Cancer Surgery. In addition, she has extensive experience in cosmetic and laser surgery and can help you attain the best possible outcome in treating your post-operative scar.