Repeated, prolonged sun exposure causes skin damage, especially in fair-skinned persons. Sun-damaged skin becomes dry and wrinkled and may form rough, scaly spots called Actinic Keratoses. These rough spots remain on the skin even though the crust or scale is picked off. Treatment of an Actinic Keratosis requires removal of the defective skin cells. New skin then forms from the deeper skin cells, which have escaped sun damage.
Actinic Keratoses can be removed surgically with a scalpel or a scraping instrument called a curette. Another way of destroying Actinic Keratoses is to freeze them with liquid nitrogen. Freezing causes blistering and shedding of the sun-damaged skin. Sometimes we’re not sure whether the growth is harmless. When this occurs we may cut the growth off and send it for microscopic analysis (biopsy). Healing after removal takes 2 – 3 weeks depending on the size and location of the keratosis. Hand and legs heal more slowly than the face. The skin’s final appearance is usually excellent.
When there are many keratoses, a useful treatment is the application of 5-fluorouracil (5-FU) or of Aldara cream. The applications are continued until your physician determines that you have the needed results. These topical creams are effective in removing Actinic Keratoses from the face. In addition, photodynamic therapy (PDT) is another effective treatment performed in the office.
Sun damage is permanent. Once sun damage has progressed to the point where Actinic Keratoses develop, new keratoses may appear even without further sun exposure. You should avoid excessive sun exposure – but don’t go overboard and deprive yourself of the pleasure of being outdoors. Reasonable sun protection should be your aim.