I Was Just Diagnosed with Actinic Keratosis — What Are My Options?

An actinic keratosis (AK) is a rough, scaly patch on your skin that develops from years of exposure to ultraviolet radiation, primarily from the sun. While AK itself isn't cancerous, it can potentially evolve into squamous cell carcinoma, a type of skin cancer. 

If you just found out that you have an AK or two, be grateful — detecting it early means you can get a jump on treatment and address it before it develops into cancer.

In the Salt Lake City area, there’s no better place to explore your AK treatment options than Holladay Dermatology and Aesthetics. Dr. Robert Topham and our team specialize in diagnosing and treating actinic keratosis and offer several evidence-based solutions.

Treatment options for actinic keratosis

Several effective treatments are available for actinic keratosis. The best one for your specific situation depends on the number, size, and location of your AK lesions and your overall health. 

1. Topical treatments

Topical medications are usually the first-line treatments for actinic keratosis. You apply these creams or gels directly to the AK, where they penetrate and cause the abnormal cells to slough off. Common topical treatments include:

• 5-fluorouracil (5-FU): a chemotherapy cream that destroys precancerous and cancerous cells
• Imiquimod: a cream that boosts your immune system to fight abnormal cells
• Diclofenac: a mild, nonsteroidal anti-inflammatory gel 

These topical treats are great for multiple AKs. For example, if you’re bald and spend time in the sun without a hat, you may have AK clusters all over your scalp. 

2. Cryotherapy

Cryotherapy is good for individual AK lesions. It freezes them with liquid nitrogen and destroys the abnormal cells, causing them to blister and eventually fall off. 

Cryotherapy is a quick, in-office procedure that typically requires no downtime, but you may have a little temporary redness and swelling.

3. Photodynamic therapy (PDT)

Photodynamic therapy combines a light-sensitizing agent with a special light source. While several agents are available, Dr. Topham uses Amulez® (aminolevulinic acid hydrochloride) gel for its superior results.

One of the most notable differences between PDT using Ameluz®  and other photosensitizing agents is its better absorption and penetration rates due to its higher concentration of aminolevulinic acid hydrochloride. 

Clinical studies show that PDT with Ameluz® clears 100% of AK lesions for over 90% of those who undergo this treatment.

4. Chemical peels

Chemical peels use various acids to exfoliate your skin. Because the process removes the outer layer of damaged skin, it also removes AKs residing in those layers and allows new, healthy skin to replace it. Chemical peels treat multiple AK lesions and improve overall skin texture.

5. Curettage and electrosurgery

Curettage and electrosurgery is a combination procedure where we scrape off the AK lesion with a curette (a sharp, spoon-like instrument) and then treat it with an electric needle to destroy any remaining abnormal cells. We usually use this method for thicker or more stubborn lesions.

Preventing actinic keratosis

While our treatments address existing lesions, we’d much rather help you prevent AKs altogether. Here are some proactive steps you can take to protect your skin from UV damage:

1. Use a broad-spectrum sunscreen with an SPF of at least 30 every day, even on cloudy days. Reapply every two hours and after swimming or sweating.
2. Wear protective clothing, like long-sleeved shirts, wide-brimmed hats, and sunglasses when spending time outdoors.
3. Avoid direct sun exposure, especially during peak hours (10am to 4pm).
4. Don’t use tanning beds; they emit harmful UV radiation that can increase your risk of skin cancer.
5. Monitor your skin for new or changing lesions, report them to Dr. Topham immediately, and see us for regular skin checks. 

If you have suspicious spots and suspect actinic keratosis, call Holladay Dermatology & Aesthetics in Holladay, Utah, to schedule a skin check.