Actinic keratosis (AK) is a common skin condition, particularly among fair-skinned Australians, characterised by rough, scaly patches that may appear white, red, or brown. These lesions develop on sun-exposed areas such as the face, scalp, ears, neck, and hands. AKs are considered precancerous because, if left untreated, they have the potential to progress into squamous cell carcinoma (SCC).
Key Features of Actinic Keratosis
- Appearance: Rough, scaly, or crusty patches on the skin.
- Common Locations: Areas exposed to the sun, including the face, scalp, ears, and hands.
- Risk Factors: Significant cumulative sun exposure, particularly in individuals over 40.
- Potential Progression: Can develop into SCC if untreated.
Prevention Strategies
- Sun Protection:
- Use broad-spectrum sunscreen with SPF 50+.
- Wear protective clothing, hats, and sunglasses.
- Avoid peak UV exposure (10 AM–4 PM).
- Avoid Tanning Beds: Reduce unnecessary UV exposure.
- Nicotinamide (Vitamin B3):
- Enhances DNA repair in skin cells.
- Reduces the incidence of actinic keratoses and non-melanoma skin cancers.
Treatment Options for Actinic Keratosis
Cryotherapy
- How It Works Liquid nitrogen is applied to freeze the lesion, causing abnormal cells to slough off.
- Best For Isolated lesions.
- Side Effects Temporary blistering or pigmentation changes.
Topical Treatments
- 5-Fluorouracil (5-FU) Cream Destroys abnormal cells.
- Imiquimod Cream Stimulates the immune system to clear precancerous and cancerous cells.
- Diclofenac Gel Inhibits abnormal cell growth.
- Uses Effective for treating multiple or widespread AKs
Photodynamic Therapy (PDT)
How It Works
- A photosensitising agent (e.g., ALA) is applied to the lesion.
- The area is exposed to specific wavelengths of light, activating the agent to destroy abnormal cells.
- Benefits Treats visible and subclinical lesions, reducing future cancer risk.
- Laser-Assisted PDT Enhances penetration of the photosensitising agent, improving efficacy for thicker or resistant AKs.
Non-Ablative Fractionated Laser
LUTRONIC ULTRA 1927, CANDELA NORDLYS 1940.
How It Works
- Targets the skin’s superficial layers, creating microthermal zones to selectively remove precancerous cells.
- Stimulates collagen production and skin regeneration.
Benefits
- Reduces the likelihood of progression to SCC.
- Improves skin texture and resilience.
- Minimal downtime with excellent cosmetic results.
Medium-Depth Chemical Peels
- How It Works Removes damaged outer skin layers to treat AK and improve skin appearance.
- Uses Effective for sun-damaged skin.
Skin Cancer and Actinic Keratosis Wraps
Ingredients
Combination of 5-fluorouracil (5-FU) cream and calcipotriol.
How It Works
- Enhances the destruction of abnormal cells through a synergistic effect.
- The area is occluded with a wrap to ensure deeper penetration of the creams.
Best For Extensive or difficult-to-treat AKs, superficial SCC in situ, and disseminated superficial actinic porokeratosis (DSAP).
Treatment Course Several applications over 9+ days with close dermatologist monitoring.
Actinic keratosis is a treatable condition that, if addressed early, can prevent progression to SCC. By combining diligent sun protection with treatments like cryotherapy, topical medications, PDT, and laser therapies, patients can effectively manage AKs and reduce their long-term risk of skin cancer. For tailored advice and treatment, schedule a consultation with our dermatology experts.
