Depending on the severity and the type of skin cancer you have, we will recommend a wide range of treatment options. Read through some of the skin cancer treatment options that we offer at Arizona Dermatology, and contact us to schedule an appointment.
A main sign of skin cancer we look for during screenings and therapies are Actinic Keartoses. In this video, we discuss in detail what Actinic Keartosis is and how we treat this rough, scaly patch caused by excessive sun exposure.
Actinic keratosis, also known as A.K.S., are precancerous conditions of the skin. When I say precancer that is really meaning basal cell and squamous cell carcinoma. These tend to develop in fair skinned individuals and more commonly on sun exposed areas.
The signs of actinic keratosis is a rough adherent scale. What most patients are going to describe them as is basically a scab that just does not want to fall off, and sometimes if they scratch it hard enough it can bleed. Approximately 10 to 30% of these can go on to develop into non-melanoma skin cancer.
Prevention of actinic keratosis is best achieved through sun protective measures. First is sunscreen. Now the important thing to know about sunscreen, that a lot of people do not know, is that S.P.F. tells you only how much U.V.B. rays it protects you from. Now that doesn’t tell you about how much U.V.A. it protects you from and U.V.A is equally causative of these. So it’s very important that when you are buying sunscreen, that it should have an S.P.F. of 30 or better, but also on the label it should say broad spectrum protection.
The other thing that works really well, they have new U.P.F. shirts which are long sleeve or short sleeve shirts and you put that on and that will alleviate the necessity to put sunscreen all over your upper body. I also recommend wide brim hats because skin cancers and precancers are very common on the ears.
Excision (Malignancies on bodily areas)
There are various modalities used when treating skin cancers. Mohs micrographic surgery is a highly specialized treatment used for skin cancers mostly on the head and neck area or cosmetically sensitive areas on the skin. The mainstay of treatment for most skin cancers is surgical excision. In regards to surgical excision, the patient is brought into the office the area where the biopsy was done is anesthetized with lidocaine mixed with epinephrine. A small margin of normal skin is taken around the area of the skin cancer. This tissue is sent to pathology where it is analyzed by a dermatopathologist under the microscope to ensure that we have clear margins.
Once the skin cancer is removed, the area of involvement is closed with surgical suture and subcutaneous sutures are placed first underneath the skin. This gives the wound support followed by cutaneous sutures on the superficial aspect of the skin. The patient is then advised to follow up in one to two weeks for suture removal.
The cancerous tumor is excised with some of the surrounding healthy tissue and is then submitted to our laboratory for the evaluation of margins. Excision has a high cure rate and can reduce the risk of cancer from reoccurring.
Electrodessication & Curettage (Superficial skin cancers)
Electrodessication and curettage is a procedure used for the treatment of skin cancers. It’s most commonly used for superficial skin cancers usually on the trunk and extremities.
A scraping is done on the top layer of skin where the initial skin cancer was located. This is followed by electrodessication of the skin surface. This is done in a checkerboard pattern and repeated two to three times until the skin cancer is adequately treated. It takes on average four to six weeks for that area to heal. The heal is left to granulate, and when I say granulate, it means to heal from the inside out so it can take a little bit longer than a surgical excision for this area to heal.
The residual effect from electrodessication and curettage. Usually it leaves a hypo pigmented or light colored scar usually around the size of a quarter depending on the size of the initial skin cancer.
The tumor and any surrounding skin affected by the cancer is scrapped off using a curette (harp spoon-like instrument). We proceed to remove the skin until we reach the healthy living tissue underneath so new healthier skin will emerge. This treatment provides great results and is less invasive than many other skin cancer procedures.
Prescription Medication (Superficial BCC’s or AK’s)
Actinic keratoses are the precursors to squamous cell skin cancer. About 1 in 10 of these lesions will progress to squamous cell skin cancer. There are various treatment modalities that we use to prevent this from occurring. Two of the most common prescription medicines we use in the treatment of actinic keratoses are Imiquimod and 5-Fluorouracil. Imiquimod works by increasing the activity of various inflammatory mediators in the skin also known as cytokines that basically act by attacking that skin abnormality or the disorganization of the cells thus halting the progression to squamous cell carcinoma.
5-Fluorouracil is another cream that we use in the prevention of skin cancer. Both of these creams are used as field treatment for skin cancers meaning they can be placed on the entire face usually for about two to three weeks at a time. Common side effects with these creams include redness, irritation and even blistering at times. These side effects can be calmed down with the use of a low potency topical steroid.
Chemotherapy for the skin works to destroy mutated cells present in actinic keratoses or superficial cancers. Based on your symptoms, needs and budget, we will work with you to find the best prescription medication for you. Some chemotherapy for the skin prescriptions include:
- Carac or Fluroplex
Cryotherapy is another treatment used for pre-cancerous lesions of the skin, as opposed to the topical medicines that are used as a field treatment for skin cancer. Cryotherapy involves directly spraying the individual lesions of the skin. When we use cryotherapy an ice crystal or an ice ball is formed within these abnormal cells causing cell destruction.
Once cryotherapy is completed the downtime, or the healing time of this process, is usually one to two weeks on average. Side effects associated with cryotherapy includes some redness, irritation, burning and even blistering. This resolves over time.
One potential complication of cryotherapy is lightening of the skin. So one must be very careful when using cryotherapy in skin of color.
The most common treatment that involves freezing an actinic keratosis, causing the skin to flake off. Overtime, new healthy skin forms as the treated areas heal.
Photodynamic Therapy – PDT or Blue Light (AK’s)
A medicated solution (Levulan) is applied to sun damaged areas and allowed to incubate. After the incubation period, a blue light is used to activate the medication and destroy precancerous growths or sun damaged tissue. This therapy gives us the ability to treat large areas in less time, instead of addressing every individual lesion.
Chemical Peels (AK’s, Sun damage)
Moderate chemical peels, such as the Vitalize Peel or Perfect Peel, can be utilized to exfoliate away actinic damaged skin. These work by burning off the damaged cells to improve the quality and health of the skin. We will work with you to find the best chemical peel based on your needs, symptoms and budget.
Resurfacing laser is another treatment for moderately severe actinic damaged skin. The top layer of skin (epidermis) is ablated or removed. Heat from the laser is penetrated in the second layer of skin (dermis) to stimulate an intense collagen reaction. The combination of ablating the epidermis and stimulating deep collagen production removes actinic keratosis skin and heals leaving you with healthy, rejuvenated skin.