Actinic Keratosis Treatment
Actinic keratoses (AKs) are dry, scaly, rough-textured patches or lesions that form on the outermost layer of the skin after years of exposure to ultraviolet (UV) light, such as sunlight. These lesions typically range in color from skin-toned to reddish brown and in size from that of a pinhead to larger than a quarter. Occasionally, a lesion grows to resemble an animal horn and is called a “cutaneous horn.”
Treatment of actinic keratosis
The Levulan PDT (Photodynamic Therapy) system is an advanced two-step treatment for minimally to moderately thick actinic keratosis and is being used by Dr. Benjamin Bassichis. First, the Levulan Keratick (aminolevulinic acid HCl) for Topical Solution, 20% is applied to individual AKs on the patient’s skin. This solution is an acid that is naturally occurring in the body and makes the AKs more sensitive to light. Next, the AKs are exposed to the BLU-U blue light. This light destroys AKs whether they are precancerous or not. Clinical testing has shown that after eight weeks of treatment, the Levulan PDT system cleared 100% of treated AKs in the majority of patients.
Cryosurgery - Liquid nitrogen “freezes” surface skin, which flakes off and is replaced by new skin. Skin redness is the chief side effect. Cryosurgery is the most commonly used treatment.
Topical Chemotherapy - A topical anti-cancer cream or lotion (e.g., 5-fluorouracil) is applied to the skin to treat and bring out actinic keratoses lesions. A localized red spot may remain for a while at the site of a treated AK.
Photodynamic Therapy - A natural chemical is applied to the skin; after a few hours, the skin is exposed to “blue” light that activates the chemical to destroy the actinic keratoses. Localized red areas develop in treated regions which fade after several days.
Freezing (cryotherapy). An extremely cold substance, such as liquid nitrogen, is applied to skin lesions. The substance freezes the skin surface, causing blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. This is the most common treatment, takes only a few minutes, and can be performed in your doctor’s office.
Creams or ointments. Some topical medications contain fluorouracil, a chemotherapy drug. The medication destroys actinic keratosis cells by blocking essential cellular functions within them. Another treatment option is imiquimod (Aldara), a topical cream that modifies the skin’s immune system to stimulate your body’s own rejection of precancerous cells.
Chemical peeling. This involves applying one or more chemical solutions — trichloroacetic acid (TCA), for example — to the lesions. The chemicals cause your skin to blister and eventually peel, allowing new skin to form. This procedure may not be covered by insurance, because it’s considered cosmetic.
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