Actinic Keratosis

What are actinic keratoses?
On sun-exposed skin, such as the forehead, scalp, ears, lips, forearms, and backs of hands, these sun-damaged spots can be seen. They have the appearance of pink, scaly, rough areas that may include crusting. 

Treatment is advised due to the slight possibility of the lesion developing into squamous cell carcinoma (the lesion becomes lumpy, painful, or bleeds). 

What is the cause?
Long-term cumulative sun exposure over the years 

What is the treatment?
An initial consultation is necessary for the diagnosis to be confirmed, either through a skin exam (usually) or a skin biopsy (if in question or if there are alterations suggestive of skin cancer); the discussion of treatment options is then required. 

The following options are available in our clinic:  

  1. Creams – 5-fluorouracil, imiquimod, or Ingenol mebutate gel can be recommended for at-home application for periods ranging from 2 days to 6 weeks. They work by inducing inflammation, which manifests as redness, discomfort, and crusting before gradually going away with treatment. 
  1. Cryotherapy – it involves freezing with liquid nitrogen. It can be done in the clinic and could need a few follow-up appointments. A little discomfort during treatment may be expected, followed by swelling, redness, blister and scab formation, and finally, clearance. Scarring and pigmentary alterations are a remote possibility. 
  1. Curettage and cautery – this is surgically scraping off the lesion under local anaesthesia, which can leave a scar. It is recommended if the diagnosis needs to be confirmed by testing the sample or if the lesion is crusty and may not be amenable to creams