Actinic keratoses are pre-cancers that form because of sun damage. We treat them to prevent them from turning into skin cancers. 

• Cryotherapy (liquid nitrogen spray) 

• • This method is very effective but, like pulling weeds, we are only treating the ones we can see or feel today, not the ones in the background that are yet to “sprout.”  

• • The treated areas may develop redness, tenderness, swelling, blistering or become sores. These are expected results. These should scab off in the next 1-2 weeks. If a sore forms, apply vaseline and a band aid. It is okay to shower and get the area wet.  

The following are “field therapies.” Like roundup, by treating the entire “field” of sun damage, they treat the precancers we can see as well as the ones growing in the background.  

• 5-Fluorouracil cream 

• • Chemo cream that targets precancers. 

• • Unless I specify otherwise, use this cream twice daily for 2 weeks. You can stop sooner if they become scabbed and irritated earlier. 

• Photodynamic therapy (PDT, red light) 

• • In-office treatment.  
  • 1. I apply a sensitizer 2. Sit in the waiting room for 30-120 minutes 3. Sit under red light to activate the sensitizer and damage the precancers. 
  • Instructions: Bring a hat to wear home after the treatment. Stay indoors as much as possible for 2 days after treatment because the sensitizer makes you more likely to burn over the next 48 hours. 

• Chemical peels 

• • In-office treatment where I apply a chemical which then causes flaking/peeling of the outer layer of skin and gets rid of pre-cancers and also improves overall texture and complexion. 
  • Peeling generally starts 2-3 days later and usually lasts for 1-2 weeks. 

Adjuvant therapies 

• Niacinamide (aka Nicotinamide) 500 mg supplement twice daily can increase your threshold for sun-induced mutations and has been shown to decrease the number of skin cancers in people with sun damage. Can buy on amazon, supplement store, and some grocery stores.