Actinic Keratoses are precancerous skin growths which appear as rough pink patches on sun exposed areas. They are often tender and can sometimes bleed. For those of you who have them- you know who you are. There are many options available to treat these lesions including cryosurgery (freezing with liquid nitrogen), topical chemotherapy (with fluorouracil cream), topical immunologic agents (imiquimod cream, diclofenac cream), chemical peels and combinations of the above. Treatment of these lesions early on will help prevent their progression to a type of skin cancer called squamous cell carcinoma.

There is an FDA approved technology called photodynamic therapy which can also help treat actinic keratoses. PDT has been around for the last decade. It is non-invasive, safe and effective. The way that PDT works is simple. A topical substance is applied on the affected areas in the doctor's office. It is left on for about an hour. This substance is called aminolevulinic acid or ALA. The skin actually then converts the ALA into a photosensitizer, which accumulates in the precancerous lesions. The patient then is exposed to a blue light with a wavelength of 417 nm for about 15 minutes, which selectively destroys the precancers. What happens then is these areas become red and crusty for about a week. Sunblock and sun avoidance is necessary for 48 hours after treatment, because the treated skin will still have amounts of photosensitizer remaining. So that means keep your hat on and sunblock on, or else you may burn very easily in the 2 days following treatment. The results are noticeable about 4 weeks after treatment, with a major reduction in the actinic keratoses. A second treatment may be necessary to clear some patients. There is also some evidence which points out that combination therapy (i.e. cryosurgery and PDT) may also be helpful for some individuals.

ALA/PDT with blue light activation is currently approved for certain actinic keratoses (AKs) of the face and scalp. Talk with your physician to see if this treatment is right for you. The above information is by no means a substitute for a visit to your doctor. For more information on these topics, please visit www.aad.org http://www.aad.org . To submit a story idea, or if you have a skin related question, please e-mail me at dracambio@gmail.com. Enjoy the last days of summer!

- Dr. Andrea Cambio
Advanced Dermatology and Cosmetic Surgery
Andrew’s Professional Center
316 Del Prado Blvd. S. Suite 201
Cape Coral 829-7102
dracambio@gmail.com

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