Medical treatment of actinic keratosis and Photodynamic therapy
Precancerous lesions such as actinic keratoses can be treated very well with non-invasive methods.
5-fluoracil 5% that inhibits the division of neoplasic cells and imiquimod 5% that acts through the immune system itself, are very effective against actinic keratoses.
They are normally applied as a cream for a few weeks at home and can produce inflammation.
The advantages over electrocoagulation or liquid nitrogen are that they are more effective, also treating the lesions that are not yet visible around it and that they produce a subsequent rejuvenation of the skin with a better cosmetic outcome.
Experience with the management of these therapies is essential. Superficial basal cell carcinoma can also be treated with imiquimod.
When multiple actinic keratoses are present, Photodynamic therapy is recommended.
This therapy consists of the application of a photosensitizing cream that selectively destroys (pre) cancer cells when activated by light. Currently, daylight is used for actinic keratoses, which is not painful. After preparation in the clinic the patient is exposed to daylight outdoors. The advantage is that many keratoses are treated in one day.