What are actinic keratoses?
Actinic keratoses are also called commonly called ‘sun-spots’. They are local areas of sun damage that are technically the first step on the path to one of the types of skin cancer, namely SCC. Therefore, it is more than a cosmetic issue to treat them; it is important to prevent skin cancer development and the scarring that can result from them and their treatment. Treating actinic keratoses also results in a marked improvement in the aesthetic appearance of the skin.
Cryotherapy
Over the years cryotherapy has been the mainstay of treatment for actinic keratoses and remains an important part of treatment for some patients. The disadvantages of cryotherapy are the several days of scabbing of the lesions after treatment, and the risk of white spots remaining at sites of treatment. It is also not possible to treat broad areas with cryotherapy due to the discomfort and difficulty healing.
Efudix cream
This is an anti-cancer cream that has been in use in dermatology for many years. It is typically applied either 1) daily for 2 weeks or 2) twice weekly for 3 months. It results in inflammation of the lesions which are usually cured once the treatment is completed. The advantages include the fact that broad areas can be treated. The main disadvantage is the prolonged downtime during which the skin is usually quite unsightly.
Imiquimod cream
This is an immune-stimulating cream that causes the body to attack the precancerous cells and destroy them. It is typically applied daily or second daily for 3 weeks. It results in inflammation of the lesions which are usually cured once the treatment is completed. The advantages include the fact that broad areas can be treated. The main disadvantage is the prolonged downtime during which the skin is usually quite unsightly and the fact that the degree of inflammation may be unpredictable, suddenly changing from mild to severe.
Fraxel laser
The Fraxel Re:store and Fraxel Peel rejuvenate all of the skin and used in various combinations, they are the best currently available treatments for addressing most of the features of sun damage. A series of three treatments has been shown to be as effect as other available treatments for actinic keratoses. The advantages include the fact that broad areas can be treated and the cosmetic outcome is superior to other methods. While treating the sun-spots, the other features of sun damage which are invariably present, are also treated. The main disadvantage is the expense in comparison to cream treatments.
Photodynamic IPL
Photodynamic IPL consists of dual-filter IPL treatment to the skin following preparation of the skin with one hour of ALA lotion. The ALA lotion is preferentially absorbed by actinic keratoses. When light such as IPL is later shone on these lesions an photochemical reaction results which destroys the pre-cancerous cells. The advantages of this are that broad areas can be treated with minimal down-time compared to other treatments and the patient also benefits from the cosmetic improvements that result from this treatment.
