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back to Actinic Keratosis

Actinic Keratoses: Medication and Post-Treatment Care

An Actinic Keratosis (AK), also known as a ‘solar keratosis,’ is a pre-cancerous condition marked by scaly, dry patches that form on sun-exposed areas of the skin including the scalp, face, forearms and back of the hands.  Topical therapy of AKs is advised, as this method allows for thorough treatment of large, sun-damaged areas, reducing the number of pre-cancerous lesions and thus decreasing the risk of future skin cancers.

Medications: Common topical medications include: Efudex, fluoroplex or Carac (fluorouracil), Aldara or Zyclara (imiquimod) or Picato (ingenol mebutate). Known as ‘immuno-moduating’ creams, these medications work with body’s own immune system, targeting DNA that has been damaged by sun exposure. 

What to expect: As skin will be inflamed for approximately one week following treatment, you may want to avoid important social engagements during this time.  Your physician will discuss an optimal treatment schedule, according to the medication prescribed and the extent of your sun damage. 

A few days to a week after beginning medication, the skin will become red, blotchy and irritated. Following treatment, the lesions will turn red, crust, peel.  Irritation in the affected areas is a sign that unhealthy cells are being destroyed. The greater the sun damage, the greater the inflammatory reaction. While this stage of treatment may be somewhat uncomfortable and you may be concerned about your appearance during this time, these effects are temporary. 

It is important that you do not stop therapy. Should there be any concern, contact our office and make an appointment so a physician can evaluate your progress.  Generally we arrange for follow-up 2 to 4 weeks into your treatment.

Self-care Instructions:
We will provide specific instructions at your visit

1. Clean treated areas by washing twice daily. Keep your skin moisturized with a bland moisturizer, like Cetaphil or CeraVe.

2. Apply enough medication to cover the lesions, being careful when applying near the eyes, nose and mouth. Be sure to wash hands after each application.

3. A thin coating of healing ointment such as Vaseline, Aquaphor or Elta moisturizer may be used near the eyelids, nostrils and lip border to minimize irritation in these areas.

4. We advise sun protection with shade and hats while undergoing this treatment.  For prolonged outdoor activity, the physical blockers of zinc and titanium dioxide are less irritating.

Contact our office if you show any signs of infection including:

  • Increased pain
  • Redness
  • Yellow crusting/discharge
  • Warmth in the affected areas

In rare cases, bacterial or herpes infections may develop, requiring oral medication.  The addition of topical steroids may alleviate discomfort in these cases. 

Once you have been seen by one of our practitioners and we have advised you to stop your topical treatment, it is important to follow our post care instructions.





Petaluma Office
165 Lynch Creek Way
Petaluma, CA 94954
 M-F, 8:00am-5:00pm
(707) 762-5531
Fax: (707) 762-5976



Hercules Office
500 Alfred Nobel Dr., Ste. 245
Hercules, CA 94547
M-F, 8:00am-5:00pm
Open Saturday for aesthetic services
 (510) 741-7418
Fax: (510) 741-7456


Billing office
Fax: 510- 741-7493

At Dermatology Associates of the Bay Area, our board-certified dermatologists serve patients at our Petaluma and Hercules offices. We are committed to the highest standards, and we offer a full range of cosmetic, medical, and surgical dermatology procedures, as well as quality skin care products.

Dermatology Associates of the Bay Area
165 Lynch Creek Way | Petaluma, California 94954 | Phone: (707) 762-5531 | Fax: (707) 762-5976
500 Alfred Nobel Drive, Suite 245 | Hercules, California 94547 | Phone: (510) 741-7418 | Fax: (510) 741-7456