Detect Treatments
for Actinic Keratoses

There are a number of treatment options available for Actinic Keratosis. These include Cryosurgery, curettage, photodynamic therapy and topical therapies, of which, can be highly successful.

1 Cryosurgery

Cryosurgery involves the process of spraying liquid nitrogen directly onto the AK lesions or applying it with cotton. This is the most common method in treating actinic keratoses. Compressed nitrous oxide or carbon dioxide may also be used.

The treatment has a success rate of between 75 and 99%, but this is highly dependent on the correct technique being applied – making it very important. It is most successful in the treatment of thin, well-defined lesion areas.

Potential adverse effects include –
  • Check for asymmetry and establish if one side of your mole is not the same as the other
  • Establish whether the mole has an irregular border such as it having ragged or blurred edges
  • The colour of your mole may have different colour tones
  • The size of the mole may be bigger than the size of a pencil eraser
  • The mole may be raised above the skin and feel uneven to the touch

2 Curettage

This involves the process of mechanically removing the AK lesions, more especially on thick, hyperkeratotic lesions. A sharp curette is used, and the process requires the use of a local anaesthesia.

Potential adverse effects include –
  • Infection
  • Scarring
  • Hypo/hyperpigmentation

3 Photodynamic Therapy

With this method of treatment, a photosensitizing agent such aminolevulinic acid (Levulan Kerastick) is applied to each Actinic Keratosis lesion, then applying light of a specific wavelength to the lesion, ultimately killing the cell. Strict protocols are used in this treatment, and in the US, only two are approved. The treatment has a success rate of between 69-93%.

Potential adverse effects include –
  • Initial erythema
  • Edema
  • Burning sensation
  • Pain
  • Crusting followed by hypo- hyperpigmentation
  • Ulceration
  • Scaling

4 Topical Therapy

There are a number of topical cream treatments available and can be useful for patients with more than a number of Actinic keratoses lesions, and have had high success rates for treatment of the face. Creams can also be used in conjunction with other medical treatments.

Potential adverse effects include –
  • Initial erythema
  • Edema
  • Burning sensation
  • Pain
  • Crusting followed by hypo- hyperpigmentation
  • Ulceration
  • Scaling

5 Cryotherapy vs. Cream Treatment

Cryotherapy –
  • Use of liquid nitrogen to burn each visible lesion
  • Only targets visible lesions
  • Field cancerization = for every lesion you see (clinical lesion) there may be as many as 10 unseen (subclinical) lesions, therefore the patient will most likely have another lesion appearing in the near future.
  • Can lead to dyspigmentation, scarring or infection
  • Can only treat a small area of skin
Cream Treatment –
  • Can apply to a larger area, therefore addressing field cancerization
  • Healing clinical (visible) and sub-clinical (ones you can’t see) lesions, therefore lower recurrence rates
  • For areas difficult to burn or excise (cut out surgically)
  • Excellent cosmetic outcome