Actinic keratosis (AK) may start as a small rough patch, but ignoring it could lead to more serious consequences. These sun-damaged spots are considered precancerous and, over time, can develop into squamous cell carcinoma. With early detection and proper treatment, you can remove actinic keratoses and significantly reduce your risk of skin cancer.
What is Actinic Keratosis?
Actinic keratosis is a common skin condition caused by long-term exposure to ultraviolet (UV) light. It’s most often seen in people with fair skin and typically develops on sun-exposed areas such as the scalp, face, ears, neck, and hands. AKs may appear as dry, scaly, or crusty patches. They can be red, pink, or skin-colored and sometimes feel like sandpaper. They can be sensitive or tender to the touch.
While not all AKs will turn into skin cancer, some do progress if left untreated. That’s why it’s essential to have any new or persistent rough spots evaluated by a board-certified dermatologist.
How to Treat Actinic Keratosis Before It Becomes Skin Cancer
The right treatment for actinic keratosis depends on the number of lesions, their location, and your overall skin condition. At Krauss Dermatology, our team offers several highly effective treatments that target and eliminate AKs.
Topical Prescriptions
For widespread or multiple AKs, topical medications may be prescribed to destroy abnormal cells over time. These include:
- 5-Fluorouracil (5-FU): A topical chemotherapy cream that treats sun-damaged skin by targeting and removing AKs. 5-FU can be combined with a Vitamin D derivative cream for a more rapid clearance.
- Imiquimod: Stimulates your immune system to attack and clear precancerous cells.
Less commonly used topicals include:
- Diclofenac Gel: A non-steroidal anti-inflammatory drug that helps slow down abnormal cell growth.
- Ingenol Mebutate: A plant-derived medication used for shorter treatment courses.
These treatments often cause redness, peeling, and irritation as the damaged cells are cleared from the skin.
Cryosurgery
Cryosurgery is a quick and effective in-office procedure that uses liquid nitrogen to freeze off the lesion. The treated area forms a blister or scab and typically heals within a couple of weeks. It’s ideal for individual AKs in small or localized areas.
Photodynamic Therapy (PDT)
Photodynamic therapy involves applying a light-sensitive medication to the skin, followed by exposure to a special blue light in our office. This treatment destroys AKs with minimal damage to healthy tissue and is especially useful for treating clusters of AKs on the face or scalp. The full face or other area is treated, thereby improving both obvious AKs and lesions that are not yet visible or palpable. There is a recuperation time of a few days to a week or two post-treatment.
Fraxel® Dual Laser
Fraxel® Dual is a non-ablative fractional laser that resurfaces the skin and targets sun-damaged cells. It treats both small visible AKs and preclinical ones not yet detectable on the surface but is more commonly used for cosmetic purposes. This laser therapy also improves texture, tone, and pigmentation, offering visible benefits alongside medical treatment. This treatment is generally not covered by insurance.
How Long Will it Take for Actinic Keratosis to Go Away?
Healing time depends on the type of treatment used.
- Cryosurgery may resolve a lesion in 1–2 weeks.
- Topical treatments typically take several weeks, with redness and peeling continuing throughout the application period.
- Photodynamic therapy often clears lesions in 7–10 days.
- Fraxel® Dual may require multiple sessions spaced several weeks apart, with gradual improvement in skin health and appearance.
A board-certified dermatologist at Krauss Dermatology will help set options and clear expectations based on your personalized treatment plan.
Will My Actinic Keratosis Come Back?
Even after successful treatment, actinic keratosis can return, especially if you continue to spend time in the sun without protection. AKs are a sign of cumulative sun damage, and people who’ve had one lesion are more likely to develop more in the future.
To reduce your risk of recurrence:
- Wear daily broad-spectrum sunscreen (SPF 30 or higher).
- Use sun-protective clothing and wide-brimmed hats outdoors.
- Avoid peak sun hours between 10 a.m. and 4 p.m.
- See your dermatologist for regular skin exams.
If you notice persistent rough spots on your skin or have a history of sun damage, schedule a consultation with Krauss Dermatology. Our experienced physicians will evaluate your skin and recommend the safest, most effective treatment to help prevent the development of skin cancer.
Take the Next Step
If you have further questions about treating actinic keratosis, we encourage you to schedule a consultation at Krauss Dermatology. Call us at (781) 247-5593 or fill out our online contact form. We look forward to taking care of you.