Solar or actinic keratosis are scaly, rough spots which occur on skin damaged by sunlight. These are distinct from other keratosis forms, such as porokeratosis, keratosis pilaris and sebhorrheic keratosis. Solar keratoses are due to abnormal development of skin cells exposed to ultraviolet radiation. They are known as precursors to cancer development. Even though solar keratoses are relatively harmless, they may be quite uncomfortable and unsightly to bear.
Treatment of solar keratosis is done by eradicating cells which are diseased. Once this has been undertaken, subcutaneous skin cells may then reproduce afresh. Not all keratoses should be removed, when carrying out treatment. Therapy focuses on eliminating tender or thickened lesions, as these pose greatest cancer risk. There are diverse procedures that may be conducted in order to relieve actinic keratosis.
Curettage and Cautery
This is the preferred method for doing away with thick keratoses and is used for removing squamous cell cancers at an early stage. A specimen is generated and sent for pathological testing in such scenario. Removal of lesion by means of scraping with sharp instrument is called curettage. Diathermy or cautery prevents bleeding by burning off keratoses. The scab later formed heals within a few weeks.
It is possible to freeze off defective skin cells by applying liquid Nitrogen on them. This method is called cryotherapy and elicits blistering and shedding of skin damaged by ultraviolet light. Treated Keratoses present on the face will peel off in 10 days or so. The ones that are on hands will do so within about 3 weeks. Those on legs can last for up to twelve weeks before healing.
Excision biopsy is literal cutting out of lesions and is important to ensure they are completely cleared away. The outcome is confirmed by pathological record. This is critical when a lesion is suspected to be cancerous.
Fluorouracil cream, also known as 5-FU or Efudix is quite an effective application for multiple facial keratoses. It is applied once or twice a day on the face for between two and four weeks.
Photodynamic therapy (PDT) is executed using a photosensitizer on the area affected first, before subjecting it to intense light radiation.
This therapy comprises of an immune response modifier contained within a base of cream. Its application on affected skin precipitates initial inflammatory reaction, eventually causes healing to occur.
Solar keratosis can be treated with Diclofenac reconstituted in hyaluran gel, with excellent results.
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