What Is The Best Treatment For Actinic Keratosis?

What is actinic keratosis?

Actinic, or solar, keratosis is damage done to the skin after prolonged UV exposure. It tends to affect people who’ve worked outside in the sun for much of their life, who live in sunny countries, who burn easily and badly, and who have fair eyes or skin.

Actinic keratosis lesions usually develop on skin that has been exposed to the sun: on bald scalps, foreheads, the backs of hands or arms, necks, shoulders or the tops of ears.

How is actinic keratosis treated?

Treatment for the condition falls into three main categories, which can be used singly or in combination. The best treatment is the one that suits you and your particular skin best.

  1. Surgery

    This is the favoured option if a patient has one (or only a couple) isolated actinic keratosis lesions, which can be scraped, frozen, lasered or peeled off. Which of these different methods (cryosurgery, chemical peel, laser surgery, or curettage and desiccation) are used will depend on the judgement of your surgeon and the state of your actinic keratosis, but they are all minor procedures which can be done fairly quickly, and with local anaesthetic.

    Cryosurgery using liquid nitrogen is the most commonly used technique, as this can be done in a few minutes in the doctor’s surgery. Very cold liquid nitrogen is applied to the lesion and causes the skin to blister and fall off, allowing healthy new skin to grow in its place.

    Side-effects can involve scarring, bleeding, blisters, infection and discolouration of the affected skin, but are usually mild.

  2. Photodynamic therapy

    This is often the preferred treatment if the actinic keratosis is widespread, rather than just one or two spots. It is a two step process: first, a chemical agent is applied over all affected skin - for example across a forehead or upper arm - to make it sensitive to light. The second step, which may take place an hour later, involves directing a special artificial light at the skin to activate the chemical agent.

    This process allows damaged cells to be destroyed, while leaving healthy skin untouched.

    It can be painful during and after the procedure, with some patients experiencing blistering, heat, soreness or swelling. They’ll also be advised to keep completely out of the sun for a day or two afterwards, while their skin is still extra sensitive to light.

  3. Topical medication

    The third strategy for treating actinic keratosis is with medication. These drugs regulate or suppress the body’s own immune system response, depending on what’s not functioning properly. Chemotherapy creams or gels can be used on widespread areas of affected skin, and are applied over the lesions to kill damaged cells.

    Side effects include inflammation and rashes where the medication has been applied.

What’s the outlook for actinic keratosis?

If actinic keratosis is treated early, there’s a very good chance that it can be managed, and the risk that it will progress to skin cancer will be much reduced. Patients are likely to have ongoing check ups with their dermatologist, as people who have already developed actinic keratosis once are at risk of developing it again.

Although actinic keratosis isn’t something you can treat with emollients, moisturising your skin with intensive, non-irritant creams or salves can help keep skin in good, healthy condition before and after any kind of treatment, especially if your treatment causes rashes, dermatitis or inflammation. We advise customers not to apply oil-based balms like Skin Salvation to skin exposed to direct sunlight, as the high oil content can cause burning and we don’t add sunscreens to our products. Apply last thing at night instead!

Recommended products:

Balmonds Skin Salvation
with hemp and beeswax

Balmonds Daily Moisturising Cream
with shea butter and calendula

Skin Conditions

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