Solar keratosis, a skin condition caused by prolonged ultraviolet exposure, is a precancerous state. Treatment varies based on the lesion’s nature, location, and severity to reduce the risk of progression to skin cancer.

Cryotherapy

Liquid nitrogen cryotherapy is a common treatment for solar keratosis. The doctor adjusts the freezing depth and duration based on the lesion’s width, thickness, and location. Facial lesions typically heal in 5-10 days, hand lesions in 3-4 weeks, and those on legs or other areas may take 6 weeks or more. Cryotherapy destroys abnormal cells and promotes skin renewal, though temporary redness and blistering may occur post-treatment.

Curettage and Electrosurgery

For thicker or proliferative lesions, curettage or electrosurgery is used. Curettage scrapes off the keratin layer with precision instruments, while electrosurgery burns off abnormal cells with high-frequency current. Tissue samples are collected during the procedure for histological analysis to rule out malignancy and ensure treatment accuracy and safety.

Surgical Excision

For larger lesions or those suspected of transformation, surgical excision offers a thorough solution. The lesion is fully removed and sent for pathological examination to confirm the diagnosis. Post-surgery, the wound is typically sutured and stitches are removed after about a week. This method ensures complete lesion removal, though careful post-operative care is needed to promote healing and prevent infection.

Broad-Area Treatments and Topical Creams

For patients with multiple solar keratosis lesions, broad-area treatments are an option. Topical creams like Diclofenac, 5-Fluorouracil, Imiquimod, and Ingenol Mebutate effectively treat sunburned areas and flat lesions. Additionally, photodynamic therapy, an emerging technique, uses specialized light and drug activation to kill abnormal cells while encouraging normal skin repair.

Other Care and Precautions

Beyond treatments, daily care is essential. Avoiding prolonged sun exposure and using sunscreen and hats when outdoors are key to preventing new lesions. Regular skin checks aid early detection, reducing progression risk. Some patients may exhibit pseudo-keratosis symptoms, distinct pathologically from solar keratosis and typically non-malignant, requiring professional diagnosis to differentiate.

Post-treatment, patients should monitor skin healing and maintain healthy lifestyle and dietary habits, as these support skin repair. Temporary pigmentation or minor scarring may occur, but with proper care, most cases improve gradually.

In conclusion, treatment options for solar keratosis are diverse, ranging from cryotherapy, curettage, and electrosurgery to surgical excision and broad-area drug therapies, each with specific indications, advantages, and drawbacks. The choice depends on lesion depth, extent, and patient condition. Doctors stress that prevention and regular checkups are equally vital for early detection and management of risks. With comprehensive treatment and proper care, patients can control the condition, enhance skin health, and minimize the risk of malignant transformation.