What should you know about removing actinic keratosis?

Actinic keratosis may be treated with freezing, prescription creams, light-activated therapy, or removal after a clinician checks the lesion. Treatment choice depends on the lesion's thickness, number, location, surrounding sun-damaged skin, and whether testing is needed.

Actinic keratosis is a rough, scaly patch caused by long-term ultraviolet exposure. It may feel sandpapery before it is easy to see and can be skin-coloured, pink, red, or brown. It often appears on sun-exposed areas such as the face, ears, scalp, forearms, and backs of the hands. A clinician may examine the area with magnification and may sample a lesion that is thick, tender, bleeding, or atypical.

Cryotherapy freezes an individual lesion and may cause a blister or crust while it heals. Imiquimod or topical 5-fluorouracil can treat selected areas of sun-damaged skin over a prescribed course and commonly cause redness, scaling, or soreness. Photodynamic therapy uses a light-sensitive medicine followed by controlled light exposure. Use the treatment exactly as prescribed, protect exposed skin with clothing and sunscreen, and avoid picking treated crusts.

Arrange prompt assessment for a patch that becomes thicker, grows quickly, is persistently tender, bleeds, forms an ulcer, or fails to heal. These changes do not prove cancer, but they can overlap with squamous cell carcinoma and may require examination or a biopsy. After treatment, contact the clinic for spreading redness, pus, fever, severe pain, or a wound that is not healing as expected.

Ask whether the lesion needs sampling, which treatment fits its site and thickness, what reaction to expect, how to protect your skin, and what follow-up schedule is appropriate.