Actinic Keratosis

Your biopsy showed an actinic keratosis. It is a precancerous growth caused by sun damage to the skin.  This has a small, but real potential to become a squamous cell carcinoma. If there is any part of this growth remaining after your biopsy, it should be treated.  

A hypertrophic or hyperplastic actinic keratosis is a variant where there is a very thick scale on the surface of the skin. It is still a precancerous growth.

It is simplest to treat it with liquid nitrogen in the office. When you come in, the area will be sprayed with liquid nitrogen, which is very, very cold. It feels like it burns. The area will then crust over, and may blister, over the next few days. It will generally heal in one to two weeks. Sometimes a lighter spot of skin will result after the treatment.  

An alternative would be a prescription cream called fluorouracil to use twice a day for two weeks. It would cause the area to become red and scaly and a little sore. It would take two more weeks to heal after, meaning it would be a four-week process. You also cannot have the area exposed to the sun during that application time.

Patients that have many actinic keratoses over a defined area may benefit from photodynamic therapy (PDT), which is an in-office procedure that treats a wide area of precancerous changes. If you think this is right for you, it’s best to schedule an appointment to discuss it further.

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