Actinic keratoses are small, red, rough patches that may feel like dry, sandpaper skin. They are a direct results of ultraviolet radiation, which is why they sometimes occur on sun-exposed areas, resembling the face, arms, and hands.
Why are actinic keratoses a priority? If left untreated, some actinic keratoses can turn into squamous cell skin cancer. Actinic keratosis may develop in roughly 40% of white patients over the age of fifty, making it probably the most common skin disease on this population. This is one of the vital common reasons people visit a dermatologist.
Field-directed treatment for multiple actinic keratosis
Cryotherapy, or the targeted application of liquid nitrogen, is often used to treat individual lesions. But what if there are various scattered actinic keratoses on the face or hands? This is when field-directed therapy—using a treatment method to treat a whole area of skin—will be helpful.
Several field-directed treatments can be found.
- A topical cream containing fluorouracil, a chemotherapy drug, works by disrupting DNA synthesis and thereby destroying actinic keratosis cells. It will be applied at home and will likely be used twice a day for 2 to 4 weeks.
- Topical imiquimod cream stimulates an area immune response within the skin, which destroys actinic keratosis cells. It will be applied at home and will likely be used two to thrice per week for as much as 16 weeks, making it an extended course of treatment than topical fluorouracil.
- Topical inginol mebutate gel actinic keratosis injures two vital components of cells—mitochondria (the powerhouse of cells) and plasma membranes (gateway components of cells)—which ends up in cell destruction. This will likely be applied at home for 3 consecutive days. Despite being convenient, many prescription plans don’t cover this drug, making the out-of-pocket cost quite expensive.
- Photodynamic therapy uses light to activate a drug that’s applied to the skin. This results in the destruction of actinic keratosis cells. It is an in-office procedure that’s performed in a day. This is a superb option for many who prefer not to use creams at home.
All of those treatments are sometimes utilized by dermatologists, but there are not any clear guidelines on which treatment to prioritize.
New study compares effectiveness of field-directed treatments
An interesting one the study Recently published New England Journal of Medicine An attempt was made to find out how effectively each of those 4 field-directed therapies treat multiple actinic keratoses. In this study, 624 patients with multiple actinic keratosis were randomized to treatment with one in every of the 4 field-directed therapies described above.
The study's primary endpoint was the share of patients who had a minimum of a 75% reduction within the variety of actinic keratoses after one 12 months. The study showed that the share of patients achieving this goal was significantly higher in those treated with topical fluorouracil (75%) than in those treated with topical imicomod (54%). were treated with photodynamic therapy (38%), and topical inginol mebutate (38%). 29%).
This seminal study highlights the vital role of field-directed treatment of actinic keratosis in reducing an individual's risk of squamous cell skin cancer.
Although this study found topical fluorouracil cream to be probably the most effective agent, other treatments should play a task. Each treatment has benefits and downsides by way of time and value, which can affect individual preferences. If you’ve gotten multiple actinic keratoses, consult with your dermatologist about which treatment is correct for you.
Follow me on Twitter. @KristinaLiuMD