New actinic keratosis treatments improve skin's appearance

Key Points

Seattle - Dermatologists' toolbox of options for treating actinic keratosis (AKs) has two promising new tools, and another may be on its way to approval by the Food and Drug Administration (FDA).

The Fraxel Dual laser system by Solta Medical and a topical therapy, Zyclara by Graceway, are among the newest options for treating AKs. Meanwhile, an investigational plant extract gel, ingenol mebutate by Leo, may make its way to the U.S. market.

On a global scale, it appears the best approach to comprehensive management of the AK patient isn't just one of these treatments, but rather sequential therapy, Dr. Werschler says.

"We can go from one therapy to another, and maybe even a third, the net result of which is an improvement in the overall clearance rate," he says.

Laser treatment

Approved in September 2010, Solta Medical's Fraxel Dual laser system adds a laser resurfacing treatment to the historic tradition of resurfacing using dermabrasion and chemical peels for AK management.

"The beauty of this system is that not only do we manage the AKs effectively, we also manage some of the other parameters of photodamage and aging, including irregular pigmentation (dyschromia), fine lines and sallowness," Dr. Werschler says. "As we manage the AKs, the patient ends up looking better in the process, and the skin is more rejuvenated than with some other AK treatments."

The treatment is described as mildly uncomfortable, has a minimal recovery period and is quickly performed in the office. The treatment, however, may be deemed by insurance companies as being primarily cosmetic and not medically necessary when other, less expensive options are available.

"The perfect candidate for Fraxel laser is someone who is equally concerned about their appearance aesthetically and about the condition of their skin medically," Dr. Werschler says.

He says the Fraxel system should be used carefully on hyperplastic or hypertrophic AKs that can be large and thick. The system is not designed to treat skin cancer.