If a physician suspects an AK to be a precancer, they may remove some tissue for a biopsy by shaving off a part of the AK with a scalpel or scraping the lesion with a curette, which is a surgical tool with a sharp ring-shaped tip.
The doctor may also use the curette to scrape off the base of the lesion. They will stop the bleeding using an electrocautery needle, or by applying trichloroacetic acid (TCA). The patient will require local anesthesia for this procedure.
Suncoast Skin Solutions, led by board certified dermatologist Dr. Christopher Ewanowski, provides advanced dermatology treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Central Florida, Florida, and surrounding locations.
There are various treatment options available for the treatment of Actinic Keratosis, depending on the patient’s age and medical condition as well as the nature of the growth. These include:
- Cryosurgery: The doctor will apply liquid nitrogen to the AK in order to freeze the tissue. Subsequently, the lesion, as well as the surrounding frozen skin, may blister or become crusty and fall off.
- Curettage and desiccation: The doctor will scrape or shave off a portion or the complete lesion. They will then apply heat or a chemical agent to stop the bleeding and potentially eliminate any remaining AK cells.
- Laser surgery: The doctor will use a strong light to vaporize the AK tissue.
For patients with multiple or widespread AKs, the doctor may prescribe a topical gel, cream, or solution. These can address visible as well as invisible lesions with minimal risk of scarring. This therapy is also known as “field therapy” as the topical treatments can cover a wide field of skin in comparison to a targeting single lesion.
- 5-fluorouracil (Carac, Efudex, Fluoroplex): A type of topical chemotherapy
- Chemical peel: These peels are renowned for reversing signs of photoaging. However, chemical peels can also effectively remove some superficial AKs on the face, specifically when other techniques have been ineffective. In this procedure, the doctor applies trichloroacetic acid and/or similar agents to the face. This causes the superficial skin layers to slough off.
- Diclofenac (Solaraze) and hyaluronic acid: A combination topical therapy.
- Imiquimod (Aldara, Zyclara): This is a type of topical immunotherapy which prompts the immune system to create interferon, which is a chemical that fights cancerous and precancerous cells.
- Ingenol mebutate (Picato): This is a quick-acting topical therapy developed from plants. An immunologic mechanism of action has been proposed.
Photodynamic therapy (PDT) is quite effective for widespread lesions on the scalp and face. The doctor applies a light-sensitizing topical agent to the lesion. They then use a strong light to activate the topical agent. This helps eliminate the AKs without harming the surrounding normal tissue.
Some doctors in Europe follow the application of the light-sensitizing agent with sunlight exposure rather than exposure to artificial light. This is called daylight PDT. It is believed to be a more gentle treatment compared to standard PDT.
For AK treatment, physicians may also combine treatments for a period of time. In general, treatment regimens combine cryosurgery with PDT or a topical agent such as diclofenac, imiquimod, 5-fluorouracil (5-FU), or ingenol mebutate.
The topical meds and PDT may also be prescribed alternately every three months, six months, or one year, as determined by the doctor at follow-up skin exams.
Dr. Christopher Ewanowski’s skin care clinic receives patients from Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Central Florida, Florida, and nearby areas for advanced skin treatments.
SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.