Treatments For Actinic Keratoses (AK) | Sarasota Dermatology | TampaTimely dermatology treatment can prevent almost all actinic keratoses (AK) from becoming skin cancers.

In case the physician suspects an AK to be early cancer, they may take a tissue sample for biopsy by trimming off a portion of the AK with a scalpel or scraping the lesion with a curette (an instrument that has a sharp ring-shaped tip).

The doctor may also use the curette to shave off the base of the lesion. They may use an electrocautery needle or apply trichloroacetic acid (TCA) to stop the bleeding. This procedure will be done with the patient under local anesthesia.

The accomplished Suncoast Skin Solutions, led by compassionate board certified dermatologist Dr. Christopher Ewanowski, provides advanced skin care treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and surrounding locations.


Treatment Options

The nature of the growth of actinic keratoses, as well as the patient’s age and medical condition, will determine the treatment. Basic treatment options include:


Surgical Procedure

The following surgical procedures are most commonly used to treat AK:



In this procedure, the physician will apply liquid nitrogen to the AK in order to freeze the tissue. Subsequently, the lesion and the frozen skin around it may blister or become crusted and fall off.


Curettage and Desiccation

The doctor will scrape or shave off a portion of the entire lesion. They will then apply heat or a chemical agent to control the bleeding as well as potentially eliminate any remaining AK cells.


Laser Surgery

In this procedure, the doctor uses intense light to vaporize the AK tissue.


Topical Treatments

In case the patient has multiple or widespread AK, the doctor may prescribe a topical gel, solution, or cream. These can address visible and non-visible lesions will minimal scarring risks. This type of treatment is also known as “field therapy” as the topical treatments can cover a wider field of skin in comparison to targeted individual lesions.

  • 5-fluorouracil (Carac, Efudex, Fluoroplex): This is a type of topical chemotherapy.
  • Chemical peel: This treatment is best known for mitigating signs of photoaging. However, it is also effective in the removal of certain superficial facial AK, especially when other techniques have proven ineffective. The doctor will apply trichloroacetic acid and/or similar chemicals to the face which will exfoliate the superficial skin layer.
  • Diclofenac (Solaraze) and hyaluronic acid: This treatment involves a combination of topical therapy.
  • Imiquimod (Aldara, Zyclara): This treatment is a type of topical immunotherapy which prompts the immune system to generate interferon. This chemical attacks cancerous and precancerous cells.
  • Ingenol mebutate (Picato): This is a fast-acting topical therapy derived from plants.


Photodynamic Therapy (PDT)

Photodynamic therapy (PDT) is particularly effective on widespread facial and scalp lesions. The physician will apply a light-sensitizing topical agent to the lesions and then use a powerful light to activate the light. This destroys the AK allowing the normal tissue to remain unharmed.

After applying the light-sensitizing agent, some doctors prefer to expose it to sunlight rather than artificial light. This is called daylight PDT, and it is believed to be a more gentle treatment in comparison to standard PDT.


Combination Therapy

Sometimes doctors may combine therapies to treat AK. In general, the treatment regimens are a combination of cryosurgery with PDT or a topical agent such as diclofenac, imiquimod, 5-fluorouracil (5-FU), or ingenol mebutate.

The doctor may also prescribe the topical meds and PDT alternately every three months, six months or one year, depending on the follow-up skin exams.

It is crucial to note that some of these treatments increase sensitivity to sunlight. Therefore, the patient should check with their physician and become especially proactive about using sun protection during the treatment period.

The skin care clinic of Dr. Ewanowski is equipped to provide cutting edge treatments to patients in Tampa, Brandon, Lutz, Seminole, Riverview, Brooksville, Winter Haven, Daytona Beach, Largo, St. Petersburg, Ocala, The Villages Central Florida, Florida, and nearby areas.

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.