What is Actinic Keratoses (Pre-Cancerous Lesions) and What are the Treatments?

Dana Kang, MD
Board-Certified Dermatologist

Actinic keratoses (AKs) are pre-cancerous lesions that can evolve into squamous cell skin cancers (SCC). The majority of AKs do not progress to skin cancer but because there is no way to know which ones will become cancerous and which ones won’t. it is recommended to treat all of them since treatment for AKs are much simpler than treatment for skin cancers. AKs, just like SCCs, are related to past sun exposure. Significant and/or multiple sunburns increases the risk of developing AKs though they don’t usually start to show until the mid to late adult years. AKs usually develop in constantly sun-exposed areas such as the face, scalp, chest, arms and hands. They usually appear as flat red or pink areas with slight to significant rough scale. Many times, AKs may not appear as anything significant so it is important to have regular skin checks by your dermatologist.

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There are various treatments for AKs. The standard treatment is with liquid nitrogen (LN2) which is a very cold spray directly applied to each AK. This will essentially give a frostbite to that area, destroying the abnormal cells leading to the skin crusting over and then sloughing off so that the skin is smooth and normal. There are also various topical treatments, such as Effudex, Aldara and Picato, which call upon your own immune system to come to the area where the cream is applied to cause a significant rash, which then irritates and destroys the abnormal cells.

Photodynamic therapy and chemical peels are in-office procedures which can also treat AKs. Your dermatologist can recommend an appropriate treatment based on your lifestyle, type of AKs and areas affected.

If you have a spot or area you’re concerned about, contact us ASAP. Take care of the problem now so it doesn’t become a massive issue later.