Actinic keratoses or AK’s:

Actinic keratoses or AK’s are small red rough spots that typically develop on the face, ears, neck, forearms, and back of the hands.

Actinic keratoses are considered pre-cancerous skin growths, and if left untreated, can result in skin cancer. Luckily, only about 1-5% of AK’s will convert to skin cancer. 

The single most significant risk factor for developing AK’s is sun exposure.

Actinic keratoses most commonly affect the elderly and fair-skinned individuals. Farmers, truckers, construction, and outdoor workers, mail-delivery individuals are particularly susceptible. 

The diagnosis of actinic keratosis is by physical examination. Sometimes a small skin test called a biopsy is required to confirm the diagnosis. 

Strict sun avoidance and the regular use of sunscreens is an essential preventative strategy. 

The most common treatment for actinic keratoses is cryotherapy. Cryotherapy involves applying or spraying liquid nitrogen or “dry ice” to the skin. Liquid nitrogen is a form of the element nitrogen that can exist in a liquid state. It is so cold that it results in a frost-bite reaction when it contacts the skin. It’s this frost-bite reaction that helps destroy unwanted skin growths.  

Cryotherapy is a straightforward and safe treatment that is performed in nearly all dermatology offices. The treatment feels like a rubber band snap and is only slightly uncomfortable. 

The areas of skin treated become swollen, red and crusted over a few days before sloughing off. Cryotherapy is often performed every 3-6 months, and multiple sessions over many years are not uncommon.

Another treatment for actinic keratoses is topical chemotherapy (applying a cream or lotion to the skin). These topical creams are used to destroy the abnormal actinic keratoses cells over a few weeks. 

The three commonly used chemotherapy cream treatments are:
  • Effudex (5-Fluorouracil) 
  • Aldara (5% Imiquimod) 
  • Zyclara (2.5% imiquimod) 

Surgery and photodynamic therapy are less common treatments that can be used for actinic keratoses.

Talk to your board-certified dermatologist to find out the best treatment for you.