Actinic Keratosis Treatment

Actinic keratosis is a type of precancer, which is an abnormality that can lead to cancer. 
The reason for treating actinic keratosis is to stop the lesion from progressing to SCC. The best treatment option will depend on how many lesions you have and where they are located. Sometimes, these treatments are used together.

Cryotherapy. Cryotherapy is the most common treatment for actinic keratosis.1 This treatment works best when there are only a few lesions that are clearly defined. Your health care provider will spray or swab liquid nitrogen on the lesion. The nitrogen freezes the lesion. This procedure is done in the office. Serious side effects are rare.1 You may feel burning or discomfort in the place that was treated. The treated spot may turn white; sometimes the discoloration improves over several months, but it can be permanent.2 You may have permanent hair loss in the treated area and long-term (12 to 18 months) loss of sensation.2

Topical medications. Actinic keratoses can be treated with medications that are applied directly to the skin. Topical medications are useful for people who have many lesions. These medications include:

  • Fluorouracil (5-FU)
  • Imiquimod
  • Diclofenac
  • Ingenol mebutate

These medications are applied to the affected area once or twice a day. Treatment with topical medications may take as little as 2 days or up to several months to work, depending on the medication used. Side effects vary by medication. They include redness, dry skin, and irritation in the treated areas.

Facial chemical peel may be an alternative to topical medications. Chemical peels can be done in a single visit.1

Photodynamic therapy. Photodynamic therapy is used to treat numerous lesions on the face and scalp.1 A light-sensitizing agent is applied to the lesions. Hours later, the lesions are exposed to a strong blue or red light that destroys the abnormal cells. Side effects include redness and swelling, burning, and pain. The skin at the treatment site may crust over, change color, or become scaly.1 After this procedure, you must stay out of the sun for at least two days.3

This treatment may be useful if your health care provider also wants to have a tissue sample from the actinic keratosis. The abnormal tissue is scraped away using a tool called a curette. Your doctor will provide local anesthesia before this procedure. Possible side effects include infection, scarring, and change in skin color.1

Written by: Sarah O'Brien | Last reviewed: May 2017.
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