Medical Dermatology

Treatment of Skin Pre-Cancers

Skin Pre-Cancers or Actinic Keratoses

Actinic keratosis, or sun-related skin precancerous scaly growths typically affect people who live in sunny environments such as ours in sunny Southern California. These patients are typically fair-skinned, have a history of chronic sun exposure or frequent sunburns. These scaly DNA-damaged growths typically occur on areas repeatedly exposed to the sun, such as the face, tops of hands, and balding scalp.

The main concern over these spots is that they predispose to squamous cell carcinoma (SCC). The risk for a patient with over 10 Actinic Keratosis to develop an SCC is over 10-15%. Because patients with AKs are sun damaged, they have a higher rate of developing not only SCCs, but Basal Cell Carcinomas, Melanomas, & rare forms of skin cancer such as Merkel cell carcinomas can be managed by several.

One important treatment that we provide is Photodynamic Therapy or PDT.

PDT is a treatment used mainly for the treatment of skin pre-cancers (called Actinic Keratosis) and has FDA approval for the treatment of these rapidly dividing skin pre-cancers. It is also commonly used off-label for facial skin rejuvenation, as well as the treatment of mild to moderate acne.

PDT utilizes Levulan (Aminolevulinic acid), a naturally occurring photosensitizing compound, to create a photochemical reaction that selectively destroys cancer cells. Levulan is applied to the skin and is subsequently “activated” by specific wavelengths of light.

The treatment of wide-spread skin pre-cancers with PDT occurs in three main stages. First, Levulan is applied to the treatment area and is left on the skin for 1-3 hours to allow the Levulan to concentrate in the pre-cancer cells. Second, you will then be placed under laser light (Blu-U) or nonlaser light (IPL) for roughly 16 minutes. Third and lastly, a sunburn-like reaction usually occurs which heals within 1-6 weeks. The treatment area should then be protected from light for 48 hours.


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