by: Dr. Elizabeth Tichy, MD
As we head into another hot Texas summer, we hear more about sunscreen and skin cancer. Technology and innovation have brought us several newer options for treatment of precancerous skin lesions. Like never before, detecting and treating early sun damage can make a big difference in the health of the skin years down the road.
The most common pre-cancerous skin finding is Actinic Keratosis (AK). The next time you are waiting in line, look at the face and backs of hands of any blue eyed, fair skinned, Texas rancher and you’ll find a few AK spots. They are typically red spots that are a little rough and often slightly tender. Many of my patients say they feel a lot like a tiny sunburn.
You do not have to have blue eyes to develop these spots, however. They happen in most skin types although they are most common in the fairer individuals.
In the past, the most popular method of treatment (in the USA at least), was to freeze each spot with liquid nitrogen. This process kills the abnormal, damaged cells and allows healthy, new cells to take their place. While it can be effective, there are several drawbacks to this treatment. First, the effectiveness of the treatment is dependent on me (the treating doctor) freezing every cell that is in the lesion. In other words, I could miss! If I leave a few cells behind (because I cannot yet see them), they will continue to grow. The next time the patient comes to my office, I might be freezing the same spot again. The second drawback is that sometimes, a small light colored scar can be left after the freezing.
Imagine 20 years of getting these spots frozen at the face as they pop up. Eventually, this can be a lot of scars that change the smooth appearance of the skin. In other words, the outcome is not always cosmetically the best with liquid nitrogen. All this being said, there are some actinic keratosis that are best treated with liquid nitrogen. The best option can only be determined at the time of the visit with the dermatologist.
Speaking of options, there are several different creams that are FDA approved or seeking FDA approval for the treatment of AK. These are a wonderful option for several reasons. Firstly, the creams are typically applied not only to the rough spot, but also to the “normal” appearing skin around the lesion. This is great because if there are any abnormal cells sneaking around nearby, the cream will recognize them and destroy them. The way that the cream works is dependent on the active ingredient in the cream. There are several available. The second largest benefit is that the vast majority of the time, there will be no scarring after treatment. That is, no white spots take the place of the original red spot. So now we have treated early spots that cannot yet be detected by the human eye and we have done it without scarring.
Taking care of our skin is a very important part of health maintenance. Discuss with your dermatologist different options for being proactive in the treatment of early sun damage. It can make a big difference in the health of your skin later.
To find out more about a new research study for AK, visit SAresearch.com or call 210.949.0122.