Actinic Keratosis (Solar Keratosis) Treatments Sydney

Treating Actinic Keratosis With Laser

There are numerous treatment options for removing Actinic Keratosis, which we will discuss further below. At Bella Plastic Surgery, we use targeted laser technology. This has the benefit of treating individual lesions while minimising the impact on surrounding tissues.

We can treat individual Actinic Keratoses on both the face and the body. Facial tissue often heals more favourably, although everyone heals differently.

After treatment, it’s normal for the treated area to become marked (change colour), and some areas of the body are more prone to visible marking or raised scar tissue. There may also be permanent changes in skin pigmentation (either lightening or darkening). However, when scarring develops, it is usually limited to the treated lesion.

Laser Treatment Limitations

Although targeted laser technology offers many benefits, it also has some limitations.

• Laser targets only lesions present at the time of the consultation and does not prevent new Actinic Keratosis from forming. (Patients should continue their ongoing sun protection efforts and always have regular skin checkups.)
• It is not possible to send a biopsy of the lesion to pathology because the laser ablates it during the procedure.
• Some lesions that have deeper components may require additional treatment to target the lesion in its entirety.
• A degree of permanent skin marking may occur, although healing outcomes vary between individuals.

Skin Cancer Assessments

As Actinic Keratosis has the potential to progress to skin cancer, all lesions must be assessed by a qualified skin cancer doctor before we commence laser treatment. This is critical to ensure appropriate treatment selection and patient safety.

Your Laser Treatment

Before we commence treatment, we’ll apply a topical anaesthetic to the area and wait for 30 to 60 minutes for it to fully numb. If required, we may also use additional local anaesthetic to ensure comfort.

You’ll be given protective eye shields to wear during the procedure.

Your treating clinician will explain each step in advance so you understand what is happening.

Individual lesions are typically removed in one session; however, further treatment may be required depending on their location and number.

Comfort During Treatment

We want you to remain comfortable during treatment. To ensure this, we use a topical anaesthetic, which is usually enough for most patients. However, if required, we can also administer a local anaesthetic into the area. These options are discussed during your initial consultation and will be tailored to address your needs and the areas treated.

Healing After Laser Treatment

A laser treatment intentionally creates a controlled injury to the skin. Therefore, after your laser treatment, it’s normal for the treated areas to be red, swollen, oozing, sensitive and tender. Usually, the tissue around the lesions is not affected. Patients are advised to anticipate some downtime.

Your treated area will develop a scab. This will gradually slough off over two weeks (or even longer). Do not pick at the scab during this time. When the scab has gone, the treated area will be red, due to new capillary formation. This redness typically subsides over the next few months.

Post-Treatment Instructions

• Keep the treated area dry until the scab has completely sloughed off.
• Avoid all sun exposure for at least four weeks.
• Avoid active skincare products for at least two weeks.
• You may use mineral makeup once healing is complete.

NB: All patients will receive verbal and written post-treatment instructions.  After-hours contact information and advice on when to seek medical attention will also be provided.

Number Of Treatments

Many individuals only need the lesion to be treated once. However, sometimes, a second treatment session will be required. Patients must be aware that, as Actinic Keratosis is caused by cumulative sun exposure, new lesions may appear and require treatment.

Follow-Up Appointment

We recommend a follow-up appointment approximately three to four days after treatment. During this appointment, a nurse will review you and administer LED therapy to support healing. If patients cannot return to the clinic, we may suggest they send photographs of the wound for review via email or text message. We may recommend further review sessions or LED treatment, depending on the patient’s healing response.

Potential Risks

When Actinic Keratosis is treated by laser, there is always a risk of infection.

Due to the nature of the ablative laser, the treated tissue cannot be sent for pathology testing.

Healing responses after laser can vary, and skin behaviour can be unpredictable. Usually, facial skin heals well; however, this cannot be guaranteed.

Pigment changes can occur in the treated area, and, in rare cases, raised scarring, such as keloid or hypertrophic scarring, can develop. This can require further management.

Your post-treatment management and all potential risks will be thoroughly discussed during your initial consultation.

Other Treatment Options

Laser is not the only treatment option for Actinic Keratosis. There are various treatment modalities offered by medical practitioners and clinics, which differ in their approach, the extent of the skin treated, recovery time, and potential outcomes. Below are some of the more commonly used non-laser treatment options.

Cryotherapy Using Liquid Nitrogen

Cryotherapy uses liquid nitrogen to freeze and destroy abnormal skin cells. While it’s commonly used, the depth and spread of freezing can be difficult to control, so results vary. In some cases, lesions are only partially removed, and the surrounding skin may also be affected. Healing, pigmentation changes, and cosmetic outcomes depend on the amount applied and the practitioner’s technique.

Curate & Energy-Based Treatments

Curettage and energy-based treatments involve mechanically removing the lesion or using energy to destroy abnormal tissue. While less commonly used for Actinic Keratosis, newer devices are available. Results can vary, and healing may be prolonged, with possible visible skin marking depending on lesion depth, treatment response and individual healing.

Photodynamic Therapy

Photodynamic therapy involves applying a photosensitising agent to the skin, followed by exposure to a specific light source to destroy abnormal cells. It is often used for larger areas of sun-damaged skin. Recovery may involve redness, discomfort, and prolonged sensitivity, and some deeper lesions may not fully respond to treatment.

Topical Field Therapies

Topical field therapies treat larger areas of skin, targeting visible and subclinical sun damage by triggering an inflammatory response. They often cause prolonged redness, soreness, crusting and visible reactions. Downtime is usually needed, and some lesions may persist or recur.

Surgical Excision and Biopsy

Surgical excision or biopsy is recommended for lesions suspicious for cancer or needing a definitive diagnosis, allowing tissue to be sent for pathology. This usually leaves a linear scar. If surgery isn’t needed, less invasive treatments may be considered based on clinical findings.

To determine the best treatment for you, you’ll need a consultation and assessment. Various factors will be considered, such as your skin type, history, lifestyle, lesion behaviour and tolerance for downtime. Your treatment selection should be discussed in detail during the consultation so that you can make an informed decision.

FAQs

What is Actinic Keratosis?

Actinic Keratosis (aka Solar Keratosis) is a sun-related skin condition caused by long-term exposure to ultraviolet (UV) radiation. It usually appears as a rough, dry or scaly patch and is often easier to feel than see. These lesions commonly develop on sun-exposed areas such as the face, scalp, ears, hands and forearms.

Is Actinic Keratosis the same as solar keratosis?

Yes. Solar Keratosis is another term for Actinic Keratosis.

What is laser treatment for Actinic Keratosis?

Laser treatment is a targeted approach that uses focused laser energy to treat an individual actinic keratosis lesion. Treatment is directed only at the identified lesion rather than a broader area of surrounding skin.

Why does Actinic Keratosis need to be assessed?

Actinic Keratosis is considered a pre-cancerous condition, as some lesions may progress over time. Assessment and ongoing monitoring by a qualified skin cancer doctor are important to ensure appropriate management.

Is laser treatment suitable for every Actinic Keratosis?

No. Each lesion must be assessed by a qualified skin cancer doctor before treatment. Lesions that appear suspicious for skin cancer require medical management and are not suitable for cosmetic laser treatment.

How many treatments will I need?

Many lesions can be treated in a single session. Some may require a follow-up treatment. Additional treatments may be needed in the future if new lesions develop or existing ones return.

Does laser treatment hurt?

Comfort levels vary between individuals. Many people tolerate treatment well with a topical anaesthetic alone. In some cases, additional local anaesthetic may be administered via needle, depending on the treatment area and sensitivity.

Can multiple lesions be treated in one visit?

In suitable cases, more than one lesion may be treated during the same appointment. Treatment time depends on the number and location of lesions.

How much does laser treatment for Actinic Keratosis cost?

Costs vary depending on the size, number and location of the lesions. Accurate pricing can only be provided after an in-person assessment and treatment plan.

Is there a Medicare rebate?

Laser treatment for Actinic Keratosis provided at this clinic is considered cosmetic and does not attract a Medicare rebate.

Can this be claimed through private health insurance?

Private health insurance rebates do not apply to cosmetic laser treatment for Actinic Keratosis.

Why can’t a price be given without seeing the lesions?

Pricing depends on how many lesions are treated, the complexity of the areas involved and the time required. A consultation allows for proper assessment and treatment planning.