Actinic Keratosis Treatment in Clovis

What Is Actinic Keratosis?

Actinic keratosis, also called solar keratosis, is a rough, scaly patch on the skin caused by years of cumulative ultraviolet (UV) radiation damage. These patches develop when UV rays from the sun or tanning beds alter the DNA in keratinocytes — the primary cells that make up the outer skin layer. The result is a cluster of abnormal, damaged cells that can feel rough or sandpaper-like to the touch, appear pink, red, or brown, and may become inflamed or itchy over time.

AKs most commonly appear on areas that receive the most sun exposure: the face (especially the nose, forehead, and cheeks), ears, scalp (particularly in men with thinning hair), lips, neck, forearms, and the backs of hands. In the Central Valley, where residents receive more annual sun exposure than much of the country, actinic keratoses are especially prevalent.

While many actinic keratoses remain stable or resolve on their own, an estimated 5 to 10% can progress to squamous cell carcinoma — a type of skin cancer — if left untreated. This is why dermatologists recommend treating all AKs rather than watching and waiting. See our skin cancer treatment page and Mohs surgery page for more on how we address skin cancer if it develops.

Signs and Symptoms of Actinic Keratosis

Actinic keratoses can vary in appearance, which is why a professional evaluation is always recommended. Common signs include:

• A rough, dry, or scaly patch of skin, typically less than an inch in diameter
• A flat to slightly raised patch on the top layer of skin
• A hard, wart-like surface in some cases
• Color variations including pink, red, or brown tones
• Itching, burning, tenderness, or a feeling of roughness in the affected area
• New patches that develop on previously sun-damaged skin

If you notice any unusual rough patches on chronically sun-exposed skin, particularly on the face, scalp, or hands, we encourage you to schedule an evaluation at Dehesa Dermatology rather than waiting. Early lesions are among the easiest and most comfortable to treat.

Actinic Keratosis Treatment Options

At Dehesa Dermatology, we individualize treatment based on the number, location, and characteristics of your actinic keratoses, as well as your overall skin health and history. Available treatments include:

• Cryotherapy (Liquid Nitrogen Freezing): The most common treatment for individual AKs. Liquid nitrogen is applied to the lesion, destroying the abnormal cells. The treated area blisters and peels over 1 to 2 weeks, revealing healthy skin beneath. Cryotherapy is fast, effective, and well-tolerated in most patients.
• Topical Field Therapy: For patients with multiple AKs in a broad area (“field cancerization”), prescription creams such as 5-fluorouracil (Efudex), imiquimod (Aldara), or diclofenac gel are applied to the entire affected region. These treatments selectively destroy abnormal cells over several weeks while sparing healthy tissue.
• Photodynamic Therapy (PDT): A two-step in-office treatment in which a photosensitizing agent is applied to the skin and then activated by a specific wavelength of light. PDT is particularly effective for widespread AKs on the face and scalp and also has cosmetic benefits including improved skin tone and texture.
• Chemical Peels: Medium-depth chemical peels using trichloroacetic acid (TCA) can be used to treat AKs in cosmetically sensitive areas while also improving overall skin quality.
• Laser Resurfacing: Our laser treatment services can be used to treat AKs in conjunction with addressing sun damage, discoloration, and wrinkles in the same session.
• Curettage and Electrodesiccation: Mechanical scraping followed by electrocautery to destroy and remove individual resistant or thickened AKs.

After treating existing lesions, we also focus on prevention — discussing your sun exposure habits, recommending broad-spectrum sunscreens, and establishing a skin check schedule to monitor for new or recurrent lesions. If an AK ever looks suspicious for squamous cell carcinoma, we will perform an in-office biopsy to confirm the diagnosis. Learn more about our approach to skin cancer diagnosis and treatment.

Who Is at Risk for Actinic Keratosis?

Anyone can develop actinic keratosis with sufficient sun exposure, but certain individuals face a higher risk. At Dehesa Dermatology, we recommend regular skin checks for patients who:

• Are over the age of 40, especially those with a history of significant outdoor sun exposure
• Have fair skin, light hair, or blue or green eyes, which offer less natural UV protection
• Have a personal or family history of skin cancer or prior actinic keratoses
• Work or spend significant time outdoors — including farmers, construction workers, landscapers, and athletes in the Fresno and Clovis area
• Have a weakened immune system due to illness, organ transplantation, or immunosuppressive medications
• Used tanning beds or experienced significant blistering sunburns earlier in life

Protecting Your Skin in the Central Valley

Clovis and Fresno are among the sunniest metro areas in the United States, with over 270 days of sunshine per year. That’s wonderful for quality of life — but it does mean that residents accumulate significant UV exposure over decades. We encourage all of our patients to make daily sun protection a habit, including broad-spectrum SPF 30 or higher sunscreen, sun-protective clothing, and avoiding peak UV hours between 10 a.m. and 4 p.m. Regular annual skin exams with a board-certified dermatologist are one of the most important steps you can take for your long-term skin health.

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Frequently Asked Questions About Actinic Keratosis