Actinic Keratoses (AKs) are the most common sunspot on Australian skin and may develop into Squamous Cell Carcinomas (SCC).
They appear as red, scaling areas of the skin on parts of the body that are frequently exposed to sunlight. Mostly, they occur on the face, ears, neck, arms and hands. They vary in size from 2mm to 20 mm in diameter and frequently “join up” to involve large areas of skin. They are not painful or itchy but may sting when exposed to sunlight or if they are rubbed or scratched. They often become more prominent in the summer.
AKs are not skin cancers, but over time they may develop into Squamous Cell Carcinomas (SCC).
They develop in response to long years of sun exposure and become more common with increasing age. AKs indicate severely sun-damaged skin and are a warning sign that the skin has become prone to all forms of cancer.
The choice of treatment depends upon whether localised lesions or whole areas/regions are to be treated. Photodynamic Therapy (PDT) is a treatment option with field treatment for larger areas.
What are the treatment options?
The choice of treatment depends upon whether localised lesions or whole areas/regions are to be treated.
Localised Treatment
Cryotherapy (liquid nitrogen)
In this technique, liquid nitrogen (which has a boiling point of a (very low) minus 200°C) is applied to the skin with the purpose of destroying surface-based tumors. It is therefore suitable for the treatment of a wide variety of benign skin lesions, including pre-malignant actinic keratoses.
Shave excision/Curettage
This is a time honoured technique used almost exclusively by dermatologists. The curette is an instrument that “scrapes” away the soft tissue that comprises the bulk of some skin cancers. Normal tissue is not affected by curetting.
CO2 Laser
SPSSCC uses the Ultra Pulse CO2 Laser to treat Actinic Keratose and some superficial skin cancers. It can also be used to reduce sun damage, to smooth scars, and to treat pigment and age spots, wrinkles and other cosmetic skin complaints.
Field treatments for larger areas
Efudix
The active ingredient of Efudix is 5 – Fluorouracil (5FU- a chemotherapy drug used successfully to treat many forms of cancer since the 1960’s. Efudix (5FU in cream form) is therefore best thought of as a chemotherapy “anticancer” cream
Aldara
This is a topically applied drug which works by stimulating the body’s own immune system to destroy cancer cells. It was actually first used in the treatment of genital warts.
CO2 Laser
SPSSCC uses the Ultra Pulse CO2 Laser for treatment of widespread actinic keratose, which are often associated with these superficial skin cancers. It can also be used to reduce sun damage, to smooth scars, and to treat pigment and age spots, wrinkles and other cosmetic skin complaints.
Combinations of the above may be employed in certain situations