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Early detection and prompt treatment can address almost all actinic keratoses (AKs) before they develop into skin cancer. 

In case a doctor suspects an AK to be a pre-cancer, they may take some tissue for a biopsy by shaving off a portion of the AK with a scalpel or scraping the lesion with a curette (a surgical tool that has a sharp ring-shaped tip). 

Additionally, the physician may use the curette to scrape off the base of the lesion. They will control the bleeding by applying trichloroacetic acid (TCA) or using an electrocautery needle. The patient will need local anesthesia for this procedure.

Suncoast Skin Solutions, led by board certified dermatologist Dr. Christopher Ewanowski, provides safe and proven skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Palm Harbor, Central Florida, and surrounding locations in Florida.


Treatment Options

Various treatment options are available to address actinic keratoses, depending on the age and medical condition of the patient as well as the nature of the growth. These treatment options include the following:

Surgical Procedures

  • Cryosurgery: The doctor applies liquid nitrogen to the actinic keratosis to freeze the tissue. After this, the lesion and adjacent frozen skin may blister or develop a crust and fall off. 
  • Curettage and desiccation: The doctor will shave off or scrape a part of the entire lesion. Then they will apply a chemical agent or heat to stop the bleeding and potentially remove any residual AK cells.
  • Laser surgery: The doctor will utilize a strong light to vaporize the tissue of the AK. 

Topical Treatments

The doctor may prescribe a topical cream, gel, or solution for patients with numerous or widespread actinic keratoses. These can treat both visible and invisible lesions with minimal risk of scarring. This treatment is also called “field therapy” as the topical treatments can address a wide field of skin compared to targeting a single lesion. 

  • 5-fluorouracil (Carac, Efudex, Fluoroplex): A form of topical chemotherapy
  • Chemical peel: These peels are known for reversing signs of photoaging. But chemical peels can also eliminate some superficial AKs on the face, particularly when other techniques have not been effective. This procedure involves the application of trichloroacetic acid and/or similar agents to the face, which causes the superficial layers of skin to slough off. 
  • Diclofenac (Solaraze) and hyaluronic acid: A combination topical therapy.
  • Imiquimod (Aldara, Zyclara): This form of topical immunotherapy encourages the immune system to produce interferon, which is a chemical that combats cancerous and precancerous cells.
  • Ingenol mebutate (Picato): This is a fast-acting topical treatment developed from plants. An immunologic mechanism of action has been proposed.

Photodynamic Therapy

Photodynamic therapy (PDT) is very effective on widespread lesions on the face and scalp. This dermatology procedure involves the application of a light-sensitizing topical agent to the lesion. After this, the doctor will use a strong light to activate the topical agent. This helps in the removal of actinic keratoses without any damage to the surrounding healthy tissue. 

Combination Therapy

The treatment of AKs may involve the use of combined treatments for a span of time. The topical medications and PDT may be prescribed alternately every three months, six months, or one year, as adjudged by the doctor at the follow-up skin examination. 

Dr. Ewanowski’s skin care clinic receives patients from Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, Sarasota, Palm Harbor, Central Florida, and nearby areas in Florida for advanced and innovative skin care procedures.

SunCoast Skin Solutions Dermatology offices are located in Tampa / Hillsborough, St. Petersburg / Pinellas County, Brandon, Lutz (2 locations), Winter Haven, Largo, Riverview, Brooksville, Ocala, Largo at Bardmoor, Daytona Beach, Sarasota, and Palm Harbor, Florida. Contact us at 1-844-786-3376 or click here.