Actinic Keratosis (cont.)
How is an actinic keratosis diagnosed?
Most of the time, doctors can diagnose an actinic keratosis just by examining
it. If the AK is especially large or thick, a biopsy may be advisable to make
sure that the spot in question is just a keratosis and has not become a skin
cancer.
There are other spots, called seborrheic keratoses, that are not caused by
sun exposure and have no relationship to skin cancers. These are raised brown
lesions that may appear on any area of the skin. They also often run in families.
How is an actinic keratosis treated?
The best treatment for an AK is prevention. For light-skinned individuals,
this means minimizing their sun exposure. By the time actinic keratoses develop,
however, the relevant ultraviolet radiation is often so far in the past that prudent
preventive measures play a relatively small role. Fortunately, treatment methods
are usually simple and straightforward:
- Cryosurgery: Freezing AKs
with liquid nitrogen often causes them to slough off and go away.
- Other forms of surgery: Doctors sometimes cut away or burn off AKs.
- 5-fluorouracil (5-FU): Creams
containing this medication cause AKs to become red and inflamed before they
fall off. Although effective, this method often produces unsightly and
uncomfortable skin for a period of weeks, thus making it impractical for many
patients. This method is best for patients who have a great deal of sun damage and many AKs. Once the skin heals, it often looks much smoother and even-toned, in addition to having fewer actinic keratoses.
- Imiquimod (Aldara): This immune stimulator is similar in its indications and effects to 5-FU.
- Photodynamic therapy (PDT): This therapy involves applying a dye (aminolevulinic acid [Levulan] or ALA) that sensitizes the skin to light, leaving it on for about one hour, and then exposing the skin to light that activates the dye. This light can come from a laser or other light source. Like 5-FU and imiquimod, photodynamic
therapy works best for patients with many AKs. Patients need to avoid exposure to sun or intense fluorescent light for two days after treatment to prevent ongoing peeling.
- Diclofenac (Solaraze): This cream is an nonsteroidal antiinflammatory drug (NSAID), an agent related to ibuprofen [Advil, Children's Advil/Motrin, Medipren, Motrin, Nuprin, PediaCare Fever], a popular medication for headaches). Diclofenac is gentler than 5-FU or
imiquimod, causing less inflammation, but must be applied for a longer period of about two months to achieve benefits.
Next: What happens after an actinic keratosis is treated? »
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