Actinic keratoses, or AK’s, are a common precancerous condition due to long-term sun exposure. They are seen on sun-exposed areas, such as the face, scalp, forearms, and hands. Actinic keratoses tend to “come and go”, and have a roughened, sandpaper-like texture. The lesions are typically red, pink, or light tan in color, usually develop slowly, and typically reach a size from one-eighth to a quarter of an inch.
Two to five percent of all actinic keratoses will progress, if untreated, into a squamous cell carcinoma, the second most common form of skin cancer. The effective treatment and prevention of actinic keratoses will minimize the risk of malignant transformation.
Liquid nitrogen is the most common treatment for actinic keratoses, particularly when there are a limited number of lesions. Liquid nitrogen is applied to the growth with a cotton-tipped applicator. No anesthesia is required, although slight stinging may be associated with the treatment. The treated area will become red, swollen, and irritated and a small blister may form. Over the course of the next several days, the lesion will crust and fall off. On occasion, an additional treatment may be necessary to completely clear the lesion.
Prescription creams and solutions are useful for treating regions that have multiple actinic keratoses. One advantage of topical medications is that they not only treat visible lesions, but also treat subclinical lesions that are small and not yet visible to the naked eye. One disadvantage of these creams is that they need to be used for several weeks, and they typically cause redness, crusting, and swelling of the treated areas.