An actinic keratosis sometimes disappears on its own, but it typically returns after more sun exposure. Because it's impossible to tell which patches or lesions will develop into skin cancer, actinic keratoses are usually removed as a precaution.
If you have several actinic keratoses, you may be better served by treating the entire affected area. Prescription products that can be applied to your skin for this purpose include:
- Fluorouracil cream (Carac, Fluoroplex, Efudex)
- Imiquimod cream (Aldara, Zyclara)
- Ingenol mebutate gel (Picato)
- Diclofenac gel (Voltaren, Solaraze)
These creams may cause redness, scaling or a burning sensation for a few weeks.
In photodynamic therapy, your doctor applies a chemical solution to the affected skin that makes it sensitive to light. He or she then exposes the area to artificial light to destroy the damaged skin cells. Side effects may include redness, swelling and a burning sensation during therapy.
Surgical and other procedures
If you have only a few actinic keratoses, your doctor may recommend removing them. The most common methods include:
- Freezing (cryotherapy). Actinic keratoses can be removed by freezing them with liquid nitrogen. Your doctor applies the substance to the affected skin, which causes blistering or peeling. As your skin heals, the lesions slough off, allowing new skin to appear. Cryotherapy is the most common treatment. It takes only a few minutes and can be done in your doctor's office. Side effects may include blisters, scarring, changes to skin texture, infection and darkening of the skin at the site of treatment.
- Scraping (curettage). In this procedure, your surgeon uses a device called a curet to scrape off damaged cells. Scraping may be followed by electrosurgery, in which the doctor uses a pencil-shaped instrument to cut and destroy the affected tissue with an electric current. This procedure requires a local anesthetic. Side effects may include infection, scarring and changes in skin coloration at the site of treatment.
Aug. 11, 2017
- Goldsmith LA, et al., eds. Epithelial precancerous lesions. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Aug. 5, 2016.
- Padilla RS. Epidemiology, natural history and diagnosis of actinic keratosis. http://www.uptodate.com/home. Accessed Aug. 5, 2016.
- Wolff K, et al. Photosensitivity, photo-induced disorders and disorders by ionizing radiation. In: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 7th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com. Accessed June 19, 2015.
- Actinic keratosis. American Academy of Dermatology. http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/a---d/actinic-keratosis. Accessed Aug. 5, 2016.
- Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2016.
- Jorizzo J. Treatment of actinic keratosis. http://www.uptodate.com/home. Accessed Aug. 5, 2016.
- FDA sheds light on sunscreens. Food and Drug Administration. http://www.fda.gov/forconsumers/consumerupdates/ucm258416.htm. Accessed Aug. 5, 2016.
- AskMayoExpert. Actinic keratosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
- Habif TP. Light-related diseases and disorders of pigmentation. In: Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Maryland Heights, Mo.: Elsevier; 2016. http://www.clinicalkey.com. Accessed June 19, 2015.
- Sunscreen FAQs. American Academy of Dermatology. https://www.aad.org/media/stats/prevention-and-care/sunscreen-faqs. Accessed Sept. 26, 2016.
- Lebwohl M. Actinic keratosis. JAMA. 2016;315:1394.