ActinicKeratosesNet Article
Why Won't My AKs Go Away?

This is a question dermatologists occasionally hear from their patients who have spent years in the sun and have developed numerous actinic keratoses (AKs). It is important for patients to realize that once extensive sun damage occurs, AK treatment is not a one-shot deal. Management of AKs becomes a lifelong process, and both the dermatologist and the patient play starring roles.

To treat patients who have extensive sun damage and numerous AKs, dermatologists may use a combination of therapies. Research shows that this approach can prove more effective than use of a single therapy and may reduce side effects. It is important for patients to know:

  • Lesions may not clear after the first treatment.
     

  • Treatment may “highlight” actinic damage that was not previously visible — a process that dermatologists call “lightening up.” While the treatment is effective on visible lesions, it also is making other lesions apparent.
     

  • A dermatologist may not treat all lesions, or may treat them at different times.

During treatment, the patient plays a key role because the effectiveness of a medication decreases significantly if not used as directed. If you have trouble with this, be sure to let your dermatologist know. Some treatment methods require more than one office visit, so it is important to keep all appointments. Your dermatologist will want to assess your progress during each visit and may modify the treatment plan accordingly.

Effective management of AKs requires that the patient follow a comprehensive sun-protection plan. Without it, the risk of developing new and recurrent AKs increases significantly because the primary cause of AKs is exposure to the sun’s ultraviolet (UV) rays.

Research shows that sun protection may allow the skin to repair some of the damage and prevent further DNA mutations caused by overexposure to the UV rays of the sun. So, it is important for patients to make sun protection a daily part of their life. Sun protection involves, but is not limited to, the daily use of a broad spectrum (offers both UVA and UVB protection) sunscreen with a Sun Protection Factor (SPF) of 30 or more, avoiding the sun between 10 a.m. and 4 p.m., and wearing sun-protective clothing. For a complete list of sun protection practices recommended by the American Academy of Dermatology, visit Prevention.

Reference:
“Guidelines of Care for Actinic Keratoses,” American Academy of Dermatology


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