Overview

Diagnosis of Actinic Keratosis

In most cases, a health care provider can diagnose actinic keratosis simply by examining your skin. The rough, scaly patches caused by long-term sun exposure are often easy to identify during a physical exam. If there’s any uncertainty, your provider may recommend a skin biopsy to confirm the diagnosis. During a biopsy, a small sample of skin is removed and examined under a microscope in a laboratory. This procedure is quick, performed under local anesthesia, and usually completed within the clinic.

Even after successful treatment, your provider may advise annual skin checkups to monitor for signs of skin cancer or the recurrence of new actinic keratoses.

Treatment for Actinic Keratosis

An actinic keratosis (AK) may sometimes fade on its own, but it often reappears after additional sun exposure. Because some actinic keratoses can develop into squamous cell carcinoma, most are treated as a precaution to prevent progression into skin cancer.

1. Medicated Creams and Gels

If multiple lesions are present, your dermatologist may prescribe topical medications to remove them, such as:

  • Fluorouracil (Carac, Efudex)

  • Imiquimod (Aldara, Zyclara)

  • Diclofenac gel

These topical treatments work by stimulating the immune system or damaging abnormal cells. Common side effects include redness, inflammation, peeling, or mild burning for a few weeks—signs that the medication is working.

2. Surgical and In-Office Procedures

Several in-office techniques can remove actinic keratoses quickly and effectively:

  • Cryotherapy (Freezing):
    The most common treatment. Liquid nitrogen is applied to freeze and destroy abnormal cells. As the area heals, new healthy skin appears. Temporary side effects include blistering, scarring, infection, or pigment changes.

  • Curettage and Electrosurgery (Scraping):
    The affected skin is scraped off with a curette, and remaining damaged tissue is treated using electric current to destroy cells. This method is performed under local anesthesia. Possible side effects include scarring, infection, and skin discoloration.

  • Laser Therapy:
    Ablative laser devices target and remove the damaged outer skin layer. Laser treatment is precise and effective, though it may cause temporary redness, scarring, or changes in skin color.

  • Photodynamic Therapy (PDT):
    A light-sensitive medication is applied to the skin and then activated with a special light to destroy precancerous cells. PDT is effective for widespread lesions but can cause short-term redness, swelling, or burning sensations.

Aftercare and Prevention Tips

  • Protect your skin daily using broad-spectrum sunscreen (SPF 30 or higher).

  • Avoid tanning beds and limit direct sun exposure, especially between 10 a.m. and 4 p.m.

  • Wear protective clothing, hats, and sunglasses when outdoors.

  • Schedule regular skin exams with your dermatologist to detect early signs of recurrence or skin cancer.

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