Mohs Surgery: Q&A

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Peel or Cream for Actinic Keratosis after Mohs Surgery?

I had Mohs surgery on November 24, 2009. It was healing nicely and overnight a purple area surfaced in the incision line. It was biopsied. It is actinic keratosis. Doctor wants to freeze next week, but I am concerned if the whole flap is bad and not just the one point in the incision line.

I have had two of ac's frozen in the past two years and then the basal cell removed in November. Should I be getting some sort of peel or cream to stop this before they surface and become something?

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actinic keratosis skin cancer

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4 Doctor Answers | Asked by jaimmersd in IL

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I would use Aldara

Aldara is a new type of topical "chemotherapy" that is FDA approved to treat and prevent Actinic Keratosis. It is also FDA approved for superficial skin cancers and genital warts. Aldara up-regulates your innate immunity to fight cancer and viruses. Dermatologists often use it adjunctively both before and after surgery. Talk to your dermatologist about this option.

Peels, Topicals, PDT Are All Good Treatments

There has been a trend among dermatologists to treat actinic keratosis with field therapy alongside what is termed lesion-directed therapy. What this means is that we are treating not just the individual lesions with cryotherapy (freezing the AK), but adding topical therapy, peels, Photodynamic therapy ( PDT), either before or after such treatment. The term field cancerization has become popular in our literature. This means that large areas of the... more

Arnold R. Oppenheim, MD

7 reviews

Virginia Beach Dermatologist

Cream vs. peel for actinic keratosis

Peels and liquid nitrogen are nonspecific methods to treat actinic keratoses and they can certainly be effective. Aldara, a prescription medication which modulates the immune system to target pre-cancerous cells can be very beneficial for clearing and preventing the development of actinic keratoses, as well as the treatment of superficial nonmelanoma skin cancers. In your case, it would be reasonable to treat the incision line with Aldara... more

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Topical chemotherapy (5 FU) for actinic keratoses or premalignant lesions

The traditional treatment for multiple actinic keratoses is the use of topical 5 Fluorouracil (i.e, Efudex) because this is actively taken up specifically by the rapidly dividing cells. Peels, however, are non-specific, and generally destroy the top layers of the skin.

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Mohs Surgery: Q&A