What Are Actinic Keratoses?
Repeated, prolonged sun exposure causes skin damage, especially in fair-skinned persons. Sun-damaged skin becomes dry and wrinkled and may form rough, scaly spots called actinic keratoses. These rough spots remain on the skin even though the scale is picked off. Treatment of an actinic keratoses requires removal of the defective skin cells. New skin then forms from the deeper skin cells, which have escaped sun damage.
Why Treat Actinic Keratoses?
Actinic keratoses are early superficial skin cancers. They should be removed because they may enlarge and invade into the skin.
How Are They Treated?
Actinic keratoses can be removed surgically with scissors or a scraping instrument called a curette. Another way of destroying actinic keratoses is to freeze them with liquid nitrogen. Freezing causes shedding of the sun-damaged skin. Sometimes we're not sure whether the growth is harmless. When this occurs I prefer to superficially cut the growth off and send it for microscopic analysis (biopsy). Healing after removal takes two to three weeks, depending on the size and location of the keratosis. Hands and legs heal more slowly than the face. The skin's final appearance is usually excellent.
When there are many keratoses, a useful treatment is the application of 5-fluorouracil (5-FU). The medication is rubbed on the keratoses for three to six weeks. 5-FU destroys sun-damaged skin cells. After one week the treated area starts to get raw. The applications are continued until your physician determines that you have the needed results. Healing starts when the 5-FU is stopped.
How Are Actinic Keratoses Prevented?
Sun damage is permanent. Once sun damage has progressed to the point where actinic keratoses develop, new keratoses may appear even without further sun exposure. You should avoid excessive sun exposure but don't go overboard and deprive yourself of the pleasure of being outdoors. Reasonable sun protection should be your aim.
