Treatment depends on how many AKs you have and where they are on your body.
If you have one or a few AKs, your dermatologist can destroy each spot. This is the most common treatment. The usual method is cryotherapy, which uses extreme cold. Your dermatologist applies liquid nitrogen to the spot. It stings for a few minutes. Within a day or two, a crust or small blister forms, and the skin heals in two to three weeks.
A dermatologist may also scrape off a spot and seal it with heat, or treat it with a cream.
If you have many AKs in one area, such as your whole face, chest, or scalp, treating each spot isn’t practical, Dr. Suozzi says. This is when treatments that cover the whole area, called field therapy, can help.
Prescription creams and gels, applied at home, play a major role. Options include:
- Fluorouracil (also called 5-FU): This cream can cause redness, irritation, and peeling during treatment. These effects go away after treatment ends.
- Imiquimod: This cream helps your immune system attack precancerous skin cells.
- Diclofenac: This gel is less irritating than other options, but it may not work as dramatically.
- Tirbanibulin (Klisyri): This newer cream is applied for about five days.
Your dermatologist can explain how long to use a product and what skin reactions to expect.
Two additional treatments are done in a doctor’s office to treat widespread AKs: photodynamic therapy (PDT) and lasers. With photodynamic therapy, your dermatologist applies a light-sensitive medicine to the whole area, then shines a red or blue light on it to destroy the damaged cells all at once.
“When we treat a patient with field therapy, we’re ‘weeding the garden,’” says Dr. Suozzi. “Since we aren’t necessarily able to get rid of all those weeds, they eventually come back. Treatment may need to be repeated, say, once a year, to maintain the clinical benefit.”
