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Actinic Keratosis Treatment

Actinic Keratosis is a condition where small rough patches or spots occur on areas of skin that have suffered prolonged sun exposure. Actinic Keratosis treatment is carried out after confirming the diagnosis and ruling out other causes of keratosis, or any cancers, after careful examination and a biopsy. While the best Actinic Keratosis treatment option is prevention, the following curative treatments are also available.

Most popular cures for Actinic Keratosis

The Crysosurgery Actinic Keratosis Treatment

Cryosurgery is the most commonly followed Actinic Keratosis treatment option. In Cryosurgery, Liquid Nitrogen, compressed carbon dioxide or Nitrous oxide is used, applied topically onto the keratosis or sprayed over it.

As a result the lesion freezes and sloughs off, effectively removing it. Actinic Keratosis treatment by cryosurgery is advantageous because it has a 75-99% cure rate, is easy to perform and is cosmetically viable too. However, adverse effects like hypopigmented or hyperpigmented patches, faint scars or local hair loss can occur. Cryosurgery is also not as effective on overgrown (hyperkeratotic hypertrophied) lesions, because of the thickness. Therefore if the lesion is debrided to a thinner lesion, cryosurgery becomes more effective.

Actinic Keratosis Treatment through curattage

Curettage of the keratosis can also be done. In curettage, a sharp curette is used to scrape away the overgrown rough tissue after anesthetizing the area. The advantage of this actinic keratosis treatment is that it can be used thick lesions, as well as for multiple scattered lesions. Curettage is itself very effective and curative, and it can be followed up by electrosurgery or cryosurgery to remove the remnants of the lesion as well. Another advantage is that the tissue that has been scraped away can be analyzed and biopsied to rule out any cancerous changes, as keratosis is a pre-cancerous condition. The disadvantages of cryosurgery include hypo or hyperpigmented patches, local scarring after curetting or infection in the wound that delays healing.

Treatment through chemical peels

Chemical peels are also under consideration for actinic keratosis treatment. Facial peels are generally employed, like Trichloroacetic Acid peels and Jessner’s solution (resorcinol, lactic acid and salicylic acid), which are equally effective as topical chemotherapy in reducing the lesion and preventing recurrence. Actinic Keratosis treatment by chemical peels is useful because only a single application is needed for small to medium lesions. Diclofenac in Hyaluronic acid gel (3%) can be used as a long term treatment, which has been found to be effective in trials. Complete resolution after twice daily applications followed by a follow up period has been noted.

However, adverse reactions like reaction on the application site, itching, dry and inflamed skin and rashes have occurred in some patients. Fluorouracil is the standard for Actinic Keratosis treatment. Topical 5% Fluorouracil is used on a twice daily basis for 10-20 days. Commonly prescribed doses include 5% (Efudex), 1% (Fluoroplex), and 0.5% (Carac) preparations. Not only can Fluorouracil be used as a treatment option, but also as an Actinic Keratosis treatment adjuvant before cryosurgery is carried out. However, adverse effects like pain, local inflammation and tenderness, rashes, dryness and stretching can occur. This is why Fluorouracil is not the most preferred Actinic Keratosis treatment option for facial lesions, as there may be some degree of disfigurement.

Another Actinic Keratosis treatment is Imiquimod

Imiquimod is an immune response modifier that is applied as a topical 5% preparation, once or twice daily, two or three days in a week for up to sixteen weeks. However, topical and systemic adverse effects like irritation, ulceration, scabbing, flu like symptoms and angioedema have been observed with Imiquimod.

Other treatments

Other topical Actinic keratosis treatment regimes include Colchicine, Tretinoin and other retinoic acid preparations in addition to fluorouracil, diclofenac and Imiquimod. However, recurrence is common after topical
treatments.

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