Actinic Keratosis
Actinic keratoses are rough, scaly patches on the skin caused by years of sun exposure. They are considered precancerous because a small percentage can develop into squamous cell carcinoma. Given Israel's high UV exposure, actinic keratoses are extremely common and should be monitored and treated.
Symptoms
- Rough, dry, or scaly patch of skin, usually less than 2.5 cm
- Flat to slightly raised patch on sun-exposed areas
- Hard, wart-like surface on the skin
- Color ranging from pink to red to brown
- Itching, burning, or tenderness in the affected area
Treatment Options
- Cryotherapy (liquid nitrogen freezing)
- Topical medications (5-fluorouracil, imiquimod, diclofenac)
- Photodynamic therapy (PDT)
- Curettage for thicker lesions
- Laser treatment for widespread areas
Why Mohs Surgery?
While Mohs surgery is not typically the first-line treatment for actinic keratosis, it may be recommended when there is concern about progression to invasive SCC, or when the lesion is in a cosmetically sensitive area.
Learn about Mohs SurgeryTreatment Comparison
| Method | Description | Best For |
|---|---|---|
| Cryotherapy | Freezing with liquid nitrogen. Quick office procedure, heals in 1-2 weeks. | Individual or few lesions |
| 5-Fluorouracil (Efudex) | Topical cream applied daily for 2-4 weeks. Causes redness and crusting during treatment. | Multiple lesions over a wide area |
| Imiquimod (Aldara) | Immune-stimulating cream applied 2-3 times weekly for several weeks. | Multiple lesions, especially on the face |
| Photodynamic therapy (PDT) | Light-activated treatment after applying a photosensitizing agent. | Large areas with many lesions |
| Curettage | Scraping the lesion under local anesthesia. | Thick or hypertrophic lesions |
| Surgical excision | Complete removal with pathological examination of margins. | Suspected progression to SCC |
Frequently Asked Questions
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Read more →This medical content was reviewed and verified by Dr. Yehonatan Kaplan on April 8, 2026