Skin cancer treatment options and prevention of Actinic keratoses (AKs)

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Skin Caner Treatment

Actinic keratoses (AKs) are considered the earliest stage in the development of skin cancer. The skin becomes more prone to the actinic keratoses with incresing age and long-term exposure to the sun. Actinic keratoses (AKs) are formed as common lesions on the epidermis, the upper most layer of the skin.

Skin cancer derived from actinic keratoses (AKs) is more prevalent in geographic areas which have a year-round high-intensity sunlight such as Florida and southern California. AKs may be found in persons as young as their teens and twenties. Half of all older, fair-skinned people who live in hot, sunny areas have AKs. The most significant predisposing factor to AKs is fair skin and long-term sun exposure.

The prevention of Actinic Keratoses

As it is the sun exposure which is the main cause of AK development, the basics of prevention are:

  • Avoiding excessive exposure to sunlight during peak sunlight hours (10am to 4pm).
  • Wearing clothing that covers arms and legs, and wear a wide brimmed hat.
  • Using a sunscreen with a sun protection factor (SPF) of 15 or higher daily. Apply at least 20 minutes prior to sun exposure for maximum sun protection.

Development of Skin cancer and Actinic Keratoses

Skin cancer develops as a result of changes brought about in keratinocytes. Chronic sun exposure causes these skin cells to change size, shape, and also the way they are organized. Changes in keratinocytes become evident when the skin becomes rough, scaly, or mottled, and develops bumps or small horn-like growths. Further changes in cell growth can turn AKs into squamous cell carcinomas, a type of skin cancer that can be quite serious in some cases.

Actinic keratoses are found on chronically sun-exposed skin, most commonly on the sides of the forehead, the ears, the scalp of bald men, and the backs of the hands. The typical AK lesion which has the potential to develop into skin cancer is a dry, scaly, and rough skin-colored to reddish-brown "bump" on the skin. AK lesions may range from the size of a pinhead to larger than a quarter. Skin-colored AK lesions may be noticed more by touch because they tend to have a sharp, hard scale and feel like sandpaper. They are often sensitive or "touchy". Wrinkling, furrowing, and other signs of sun damage may be present along with AK lesions.

An actinic keratosis can also appear as a scaling lesion on the lower lip that dries and cracks open. An AK at any location may at times seem to disappear for weeks or months and then return at the same place. If they are picked off they grow back unless they are removed by some anti cancer treatments.

Any anti skin cancer treatment can be very effective for treating AKs if their formation is prevented early in life. Sun damage to unprotected skin begins in childhood and puts the child at risk for actinic keratoses and skin cancer later in life. However, it is never too late to initiate prevention of new actinic keratosis lesions in adulthood.

Skin cancer treatment options

  1. Cryosurgery,
  2. Surgical removal and biopsy,
  3. Topical chemotherapy,
  4. Chemical peels
  5. Laser skin resurfacing
  6. Photodynamic therapy
Cryosurgery - Cryosurgery has been used to treat skin lesions for approximately 100 years. The first cryogens were liquid air and compressed carbon dioxide snow. Liquid nitrogen became available in the 1940s and currently is the most widely used cryogen. The cryogens are very cold. They are applied to the skin and they freeze the damaged or cancerous skin and kill it. The dead skin then sloughs off.

Surgical removal & topical chemotherapy - These cancer treatment therapies are quite frequently used when the cancers do not respond to the other therapies. Surgery is needed when skin cancers have grown larger and deeper into the skin.

Chemical Peeling - A chemical solution is applied to the skin. This causes the skin to peel off over a period of days. As the treated skin peels, new skin forms replacing the pathological cells containing the cancer growth.

Laser Skin Resurfacing - A series of laser resurfacing treatments with a carbon dioxide laser removes surface skin to a desired depth. Post-treatment skin redness is the principal side effect. A week or two of healing is needed. Laser skin resurfacing can be very effective for the removal of superficial skin cancers.

Treatment with Photo dynamic therapy

Photodynamic therapy is a treatment modality that is developing rapidly and becoming increasingly popular as skin cancer treatment. The technique requires the presence of a photosensitizer, light energy and molecular oxygen to selectively destroy pathologic cancer cells.

Photodynamic therapy has been approved by the US Food and Drug Administration to treat actinic keratoses. In Europe, photodynamic therapy is currently being used in the treatment of actinic keratoses and basal cell carcinoma, a form of skin cancer. As a skin cancer treatment the therapy has been proved to be very effective, but the therapy requires a thorough understanding of photobiology and tissue optics to correctly and effectively utilize photodynamic therapy in skin cancer treatment and other areas of skin rejuvenation dermatology.

All the treatment options should be fully and openly discussed with your dermatologist and/or dermatologic surgeon.

After AKs are removed, the new skin must be protected from new solar damage by a program of skin care that includes sun protection and use of sun block.