Actinic Keratosis Treatments
Prompt treatment can remove almost all actinic keratoses (AK) before they develop into skin cancer. Patients with suspicious AK may have to undergo a biopsy which involves having a part of the AK removed with a scalpel or curette (a tool with a sharp ring-like tip).
Scraping the lesion’s base is also possible with a curette. The physician will use an electrocautery needle or apply trichloroacetic acid (TCA) to stop the bleeding, and the patient will require local anesthesia.
Judicious board certified dermatologist Dr. Jamie McGinness and Jackie McGinness, FNP (Nurse Practitioner), who both treat general derm patients, provide skin care treatments to patients in Shiloh, IL; St. Louis, MO, and surrounding communities.
The treatments available for AK, depending on the type of growth’s and the patient’s medical state and age, are as follows:
- Cryosurgery: This treatment involves the use of liquid nitrogen on the AK to freeze the tissue. The lesions and the skin around it will blister and fall off after some time.
- Curettage and desiccation: The doctor will scrape or shave off a portion or the entire lesion. They will then apply heat or a chemical agent to stop the bleeding and eliminate any remaining AK cells.
- Laser surgery: The doctor uses intense light to ablate the AK tissue.
The physician may prescribe a topical gel, cream, or solution if the patient has multiple or widespread AK. These topical ointments can address visible and invisible lesions with minimal scarring risks. This type of therapy is also called “field therapy” as these treatments cover a wide area of skin compared to targeting specific lesions.
- 5-fluorouracil (Carac, Efudex, Fluoroplex): A type of topical chemotherapy.
- Chemical peel: These peels reverse signs of photoaging and can also eliminate certain superficial AK on the face. The doctor will apply trichloroacetic acid and/or similar agents to the face which causes the superficial skin layer to exfoliate.
- Diclofenac (Solaraze) and hyaluronic acid: This is a combination topical treatment.
- Imiquimod (Aldara, Zyclara): This therapy is a type of topical immunotherapy, which prompts the immune system to generate interferon. This is a chemical that destroys cancerous and precancerous cells.
- Ingenol mebutate (Picato): This is a fast-acting and plant-based topical treatment.
Photodynamic Therapy (PDT)
For patients with widespread lesions on the scalp and face, Photodynamic therapy (PDT) is particularly useful. The doctor will apply a light-sensitizing topical chemical to the lesions. They will subsequently use a powerful light to activate the topical agent, destructing the AKs while leaving the healthy tissue unaffected.
Some doctors expose the treatment areas t0 sunlight after applying the light-sensitizing agent, rather than using artificial light. This is called daylight PDT and is believed to be gentler than standard PDT.
Physicians may use a combination of therapies to address AKs. In general, the treatment regimens are a combination of cryosurgery with PDT or a topical therapy such as diclofenac, imiquimod, 5-fluorouracil (5-FU), or ingenol mebutate.
The topical meds and PDT can also be alternated every three months, six months, or one year as recommended by the doctor at the follow-up skin exams.
Notably, the patient may experience an increase in sun sensitivity with some of these therapies. Therefore, it is important to check with the physician and be particular about the use of sun protection during the treatment.
Reliable board certified dermatologist Dr. Jamie McGinness and Jackie McGinness, FNP (Nurse Practitioner) receive patients from Shiloh, IL; St. Louis, MO, and nearby areas in this section of the Midwest for various skin treatments.
If you would like to learn more about procedures and treatments at Metro East Dermatology & Skin Cancer Center by Board Certified Dermatologist Dr. Jamie L. McGinness please contact us here or call (618) 622-SKIN (7546)
Taking new patients in and around the greater St. Louis, Missouri and Illinois area: East St. Louis Missouri, Shiloh Illinois, Belleville, Millstadt, Saint Clair County, Madison County and more.