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Harvard Medical School
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General Medical Questions
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Question : What is the best treatment for an actinic keratosis? What are the risks or side effects?
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The Trusted Source
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Rebecca Campen, M.D., J.D., is an assistant professor of dermatology at Harvard Medical School. She divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, Ga.

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May 17, 2011
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A:

Actinic keratoses are rough, scaly areas on skin that often feel like sandpaper. They are found on areas of the body exposed to the sun. They are precancers, which mean they could turn in to squamous cell skin cancers if they are not treated.

People with light skin are more susceptible to getting actinic keratoses, but everyone can get them. That's why it is important to protect the skin by wearing sunscreen and protective clothing.

There are several ways to treat actinic keratoses. A dermatologist can spray liquid nitrogen on these precancers. The area will often then blister, and the precancer can go away in two to three weeks. If it does not go away, it should be retreated or biopsied.

Actinic keratoses can also be shaved or scraped off, if the number of precancers is not large. To avoid infection, you will need to apply antibiotic ointment and keep the area clean.

Prescription creams (such as Efudex, Carac and Aldara) can be used to treat actinic keratoses. The cream is applied for two or three weeks. The skin will become irritated and sometimes bleed, but usually these precancers go away.

Photodynamic therapy can treat actinic keratoses. A photosensitizing substance is applied to the skin. The skin is then exposed to a light source such as ultraviolet light. The photosensitizing substance soaks into the actinic keratoses and is "activated" by the light source. This destroys the precancers. There is some pain with this process, but it usually lasts only five to ten minutes. You must avoid sun exposure for at least forty-eight hours after the treatment and wear sunscreen diligently.

See your doctor for regular skin exams and to talk about options for removing your actinic keratoses.

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