Actinic keratoses are precancerous conditions which can transform into skin spinocellular carcinoma. Each keratosa may not turn to carcinoma, but there is an enlarged risk of that happening. For this reason a constant check up of keratoses and their removal is needed. Keratoses are caused by long sun exposure. They appear exclusively in areas which were exposed the longest: scalp, forehead, nose, cheeks, decollete, fists, forearms and lower legs. Longtime sun exposure causes damage to the genetic material which then causes an uncontrolled cell growth.
Initially they are light or brown spots which in time turn darker and thicker. In time their surface becomes dry and can peel. Size and shape vary significantly, as does their number.
Current methods are based on mechanical destruction. For this purpose we mainly use freezing. All other methods based on mechanical removal can be used as well. Lasers and AFT treatments are a huge innovation in their treatment. With initial keratoses, peeling and oxygen micro-abrasion are a method of choice. Aft treatment destroys the keratoses with optical energy and rejuvenates the skin and is recommended as a prevention of development of keratoses in people with sun damaged skin or with initial stages of keratoses. Erbium and Co2 lasers are excellent for removal of thicker keratoses. Fractional lasers give best results in removing initial and moderately thick keratoses and in prevention of development. By using lasers not only do we remove keratoses but we decrease the activity of the gene responsible for the mutation, i.e. damage of the genetic material. From agents that can be used at home we have at our disposal non-steroidal anti-inflammatory drugs, local retinoids, imiquimod and peelings. Photo-dynamic therapy gives best results, but this method is extremely painful and unpleasant and a long recovery is needed. The method is based on illuminating keratoses with light of a certain wave length with smearing a special compound which activates and destroys the keratose under illumination.
It is necessary to protect yourself from sun exposure at an early age and use footwear, clothes and hats to prevent skin damage. Along with that, the most important role lies in the regular usage of high protective factors.